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维持性血液透析患者的血清瘦素浓度与左心室肥厚及功能

Serum leptin concentration and left ventricular hypertrophy and function in maintenance hemodialysis patients.

作者信息

Nasri H

机构信息

Shahrekord University of Medical Sciences, Hajar Medical, Educational and Therapeutic Center, Department of Internal Medicine, Shahrekord, Iran.

出版信息

Minerva Urol Nefrol. 2006 Jun;58(2):189-93.

PMID:16767072
Abstract

AIM

The aim of the study was to investigate the potential relationship between left ventricular hypertrophy (LVH) and left ventricular ejection fraction with serum leptin in end-stage renal failure patients undergoing regular hemodialysis (HD) treatment.

METHODS

A cross-sectional study was carried out on 41 patients (15 women, 26 men) with end-stage renal disease (ESRD), undergoing maintenance HD treatment with acetate basis dialysate and polysulfone membranes. Serum leptin, pre- and post-dialysis creatinine, predialysis BUN, calcium (Ca), phosphorus (P), serum albumin (Alb) and serum ferritin were monitorized; the patients were categorized into no LVH, mild , moderate and severe LVH, according to the performed echocardiographies.

RESULTS

The mean patient's age was 46+/-17.6 years. The mean length of the time patients had received HD was 29.5+/-34 months (median: 18 months). The mean serum leptin was 9.5+/-13.8 ng/mL (median value 4.7 ng/mL). In this study no significant association between stages of LVH with serum leptin was seen. In this study a significant positive correlation between LV ejection fraction with logarithm of serum leptin (r=0.32, P=0.048) (adjusted for age, duration and doses of dialysis, BMI, diabetes mellitus, serum ferritin, Ca, P and serum Alb was observed).

CONCLUSIONS

Leptin might not be an aggravator for LV hypertrophy. This behavior of leptin in maintenance HD patients which is in contrast to general population, especially in obese patients with normal renal function could be explained through its reverse epidemiology role in HD patients. Our results emphasize the importance of leptin in HD and clinical impact of these findings merit further investigation.

摘要

目的

本研究旨在探讨接受规律血液透析(HD)治疗的终末期肾衰竭患者左心室肥厚(LVH)及左心室射血分数与血清瘦素之间的潜在关系。

方法

对41例终末期肾病(ESRD)患者(15例女性,26例男性)进行横断面研究,这些患者使用醋酸盐基础透析液和聚砜膜进行维持性HD治疗。监测血清瘦素、透析前后肌酐、透析前尿素氮、钙(Ca)、磷(P)、血清白蛋白(Alb)和血清铁蛋白;根据所做的超声心动图检查,将患者分为无LVH、轻度、中度和重度LVH。

结果

患者的平均年龄为46±17.6岁。患者接受HD治疗的平均时间为29.5±34个月(中位数:18个月)。血清瘦素的平均值为9.5±13.8 ng/mL(中位数为4.7 ng/mL)。在本研究中,未发现LVH分期与血清瘦素之间存在显著关联。在本研究中,观察到左心室射血分数与血清瘦素对数之间存在显著正相关(r = 0.32,P = 0.048)(校正年龄、透析时间和剂量、BMI、糖尿病、血清铁蛋白、Ca、P和血清Alb后)。

结论

瘦素可能不是左心室肥厚的加重因素。维持性HD患者中瘦素的这种行为与普通人群相反,尤其是在肾功能正常的肥胖患者中,这可以通过其在HD患者中的反向流行病学作用来解释。我们的结果强调了瘦素在HD中的重要性,这些发现的临床影响值得进一步研究。

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