Shoji Tetsuo, Shinohara Kayo, Hatsuda Sawako, Kimoto Eiji, Fukumoto Shinya, Emoto Masanori, Tahara Hideki, Koyama Hidenori, Ishimura Eiji, Miki Takami, Tabata Tsutomu, Nishizawa Yoshiki
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Metabolism. 2005 Mar;54(3):330-4. doi: 10.1016/j.metabol.2004.09.012.
Patients with end-stage renal disease (ESRD) show an inverse association between body mass index and risk of death from cardiovascular disease. Paradoxical epidemiology may suggest some beneficial effects of body fat in ESRD. Because an antiatherogenic adipocytokine adiponectin is increased in uremic plasma, we tested a hypothesis that, in ESRD, plasma adipocytokine profile may be less atherogenic or that the relationship between body fat and adipocytokines may be altered. The subjects were 103 patients with ESRD undergoing hemodialysis and 166 healthy subjects comparable in age and sex. We measured body fat mass by dual-energy x-ray absorptiometry and plasma levels of adiponectin and leptin by enzyme-linked immunosorbent assay. The ESRD group showed a significant increase in plasma adiponectin, leptin, and adiponectin/leptin ratio than the healthy subjects. Although sex and fat mass were significant factors correlating with plasma adiponectin level in the healthy group, none of these were significantly associated with plasma adiponectin in the patients with ESRD. In contrast, leptin showed significant relationships with sex and fat mass regardless of the presence of ESRD. Plasma adiponectin correlated negatively with plasma triglycerides and positively with high-density lipoprotein cholesterol in both healthy and ESRD groups, suggesting that uremic adiponectin retains its actions in favor of its antiatherogenicity. Thus, plasma adipocytokine profile was altered in ESRD, and the effects of body fat and sex on adiponectin were less significant in the patients with ESRD.
终末期肾病（ESRD）患者的体重指数与心血管疾病死亡风险呈负相关。这种矛盾的流行病学现象可能提示身体脂肪在ESRD中具有一些有益作用。由于尿毒症血浆中抗动脉粥样硬化的脂肪细胞因子脂联素增加，我们检验了一个假设，即在ESRD中，血浆脂肪细胞因子谱的动脉粥样硬化性可能较低，或者身体脂肪与脂肪细胞因子之间的关系可能发生改变。研究对象为103例接受血液透析的ESRD患者和166例年龄和性别匹配的健康受试者。我们通过双能X线吸收法测量身体脂肪量，并通过酶联免疫吸附测定法测量血浆脂联素和瘦素水平。ESRD组的血浆脂联素、瘦素及脂联素/瘦素比值均显著高于健康受试者。虽然在健康组中，性别和脂肪量是与血浆脂联素水平相关的显著因素，但在ESRD患者中，这些因素均与血浆脂联素无显著关联。相反，无论是否存在ESRD，瘦素均与性别和脂肪量呈显著相关。在健康组和ESRD组中，血浆脂联素均与血浆甘油三酯呈负相关，与高密度脂蛋白胆固醇呈正相关，提示尿毒症脂联素保留了其抗动脉粥样硬化的作用。因此，ESRD患者的血浆脂肪细胞因子谱发生了改变，且身体脂肪和性别对脂联素的影响在ESRD患者中不那么显著。
