Komaba Hirotaka, Igaki Naoya, Goto Shunsuke, Yokota Kazuki, Takemoto Toshiyuki, Hirosue Yoshiaki, Goto Takeo
Department of Internal Medicine, Takasago Municipal Hospital, Takasago, Japan.
Nephron Clin Pract. 2007;107(3):c103-8. doi: 10.1159/000108651. Epub 2007 Sep 21.
Adiponectin, an adipocyte-derived hormone, has been shown to prevent the progression of left ventricular hypertrophy (LVH). However, recent studies have demonstrated increased levels of adiponectin according to the severity of chronic heart failure. We therefore investigated the relationships between adiponectin, brain natriuretic peptide (BNP), and LVH in type 2 diabetic patients on hemodialysis.
The study population comprised 41 type 2 diabetic patients on hemodialysis. Left ventricular mass index (LVMI) and criteria for LVH were determined on the basis of echocardiographic findings. Serum adiponectin and plasma BNP levels were assayed with a commercially available kit.
Serum adiponectin levels significantly correlated with BMI (r = -0.49, p < 0.01), HDL-C (r = 0.36, p < 0.05) and TG (r = -0.49, p < 0.01). In addition, serum adiponectin levels correlated significantly and positively with plasma BNP levels (r = 0.36, p < 0.05). This relationship remained significant after adjustment for age, gender, and BMI (r = 0.34, p < 0.05). Serum adiponectin levels as well as plasma BNP levels were significantly higher than in patients without LVH (p < 0.05; p < 0.01, respectively), accompanied by a positive correlation between these levels and LVMI (r = 0.42, p < 0.01; r = 0.32, p < 0.05, respectively).
Increased levels of adiponectin were associated with elevated BNP levels and LVH in hemodialysis patients with type 2 diabetes mellitus. It is speculated that adiponectin levels may be modulated by chronic hypervolemic state in this population.
脂联素是一种脂肪细胞衍生的激素，已被证明可预防左心室肥厚（LVH）的进展。然而，最近的研究表明，根据慢性心力衰竭的严重程度，脂联素水平会升高。因此，我们研究了2型糖尿病血液透析患者中脂联素、脑钠肽（BNP）和LVH之间的关系。
研究人群包括41名接受血液透析的2型糖尿病患者。根据超声心动图检查结果确定左心室质量指数（LVMI）和LVH标准。使用市售试剂盒测定血清脂联素和血浆BNP水平。
血清脂联素水平与BMI显著相关（r = -0.49，p < 0.01）、HDL-C（r = 0.36，p < 0.05）和TG（r = -0.49，p < 0.01）。此外，血清脂联素水平与血浆BNP水平显著正相关（r = 0.36，p < 0.05）。在调整年龄、性别和BMI后，这种关系仍然显著（r = 0.34，p < 0.05）。血清脂联素水平以及血浆BNP水平均显著高于无LVH的患者（分别为p < 0.05；p < 0.01），这些水平与LVMI呈正相关（分别为r = 0.42，p < 0.01；r = 0.32，p < 0.05）。
在2型糖尿病血液透析患者中，脂联素水平升高与BNP水平升高和LVH相关。推测该人群中脂联素水平可能受慢性高血容量状态调节。
