血液透析患者的血清和细胞白细胞介素-6：与能量消耗的关系。
Serum and cellular interleukin-6 in haemodialysis patients: relationship with energy expenditure.
作者信息
Kamimura Maria A, Draibe Sergio A, Dalboni Maria A, Cendoroglo Miguel, Avesani Carla M, Manfredi Silvia R, Canziani Maria E F, Cuppari Lilian
机构信息
Nutrition Program, Federal University of São Paulo, Rua Pedro de Toledo, 282 Cep: 04039-000 São Paulo, SP, Brazil.
出版信息
Nephrol Dial Transplant. 2007 Mar;22(3):839-44. doi: 10.1093/ndt/gfl705. Epub 2007 Jan 5.
BACKGROUND
Inflammation is a highly prevalent condition among end-stage renal disease (ESRD) patients and it has been implicated with several metabolic derangements. Considering the harmful effect of hypermetabolism on nutritional status and clinical outcomes of ESRD patients, we aimed to investigate the relationship between proinflammatory cytokine interleukin-6 (IL-6) and energy expenditure in this population.
METHODS
This cross-sectional study enrolled 80 adult haemodialysis patients for the evaluation of serum IL-6 and energy expenditure. The production of IL-6 by peripheral blood mononuclear cells (PBMCs) (spontaneous and endotoxin-stimulated production) was examined in a subgroup of 30 haemodialysis patients and in 11 healthy control subjects. IL-6 was measured by immunoenzymatic assay. The resting energy expenditure was evaluated by means of indirect calorimetry. Body composition was assessed by bioelectrical impedance analysis and skinfold thicknesses.
RESULTS
Serum IL-6 [6.3 (2.2-163.5) pg/ml] correlated positively with age (R = 0.26; P = 0.02) and C-reactive protein (R = 0.31; P < 0.01). Resting energy expenditure correlated positively with lean body mass (R = 0.68; P < 0.001) and BMI (R = 0.44; P < 0.001), and negatively with Kt/V (R = -0.37; P < 0.01). In the multivariate analysis, controlling for age and lean body mass, serum IL-6 was positively associated with resting energy expenditure (n = 80; beta = 2.4; P = 0.01). The production of IL-6 by PBMCs did not reach statistically significant differences between patients and controls [spontaneous production 6541 (96-7739) pg/ml vs 3410 (50-7806) pg/ml, respectively; and stimulated production 6530 (579-7671) pg/ml vs 5304 (1527-7670) pg/ml, respectively]. IL-6 secreted by monocytes showed no association with either serum IL-6 or resting energy expenditure.
CONCLUSION
Serum IL-6 was associated with an increase of energy expenditure in haemodialysis patients.
背景
炎症在终末期肾病（ESRD）患者中极为普遍，且与多种代谢紊乱有关。鉴于高代谢对ESRD患者营养状况和临床结局的有害影响，我们旨在研究促炎细胞因子白细胞介素-6（IL-6）与该人群能量消耗之间的关系。
方法
这项横断面研究纳入了80名成年血液透析患者，以评估血清IL-6和能量消耗。在30名血液透析患者亚组和11名健康对照受试者中检测外周血单核细胞（PBMC）产生IL-6的情况（自发和内毒素刺激产生）。通过免疫酶测定法测量IL-6。通过间接测热法评估静息能量消耗。通过生物电阻抗分析和皮褶厚度评估身体成分。
结果
血清IL-6[6.3（2.2 - 163.5）pg/ml]与年龄呈正相关（R = 0.26；P = 0.02），与C反应蛋白呈正相关（R = 0.31；P < 0.01）。静息能量消耗与瘦体重呈正相关（R = 0.68；P < 0.001），与BMI呈正相关（R = 0.44；P < 0.001），与Kt/V呈负相关（R = -0.37；P < 0.01）。在多变量分析中，在控制年龄和瘦体重后，血清IL-6与静息能量消耗呈正相关（n = 80；β = 2.4；P = 0.01）。患者和对照组之间PBMC产生IL-6的差异无统计学意义[自发产生分别为6541（96 - 7739）pg/ml和3410（50 - 7806）pg/ml；刺激产生分别为6530（579 - 7671）pg/ml和5304（1527 - 7670）pg/ml]。单核细胞分泌的IL-6与血清IL-6或静息能量消耗均无关联。
结论
血清IL-6与血液透析患者能量消耗增加有关。
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