Park Jae-Ho, Gil Hyo-Wook, Yang Jong-Oh, Lee Eun-Young, Hong Sae-Yong
Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Nephrology (Carlton). 2008 Jun;13(3):181-5. doi: 10.1111/j.1440-1797.2008.00930.x.
Adiponectin is an antiatherogenic adipocyte-derived proteins. The level of plasma adiponectin is inversely correlated to cardiovascular risk in patients with end-stage renal disease (ESRD). The aim of this study was to elucidate the changes of adiponectin concentrations in newly diagnosed ESRD patients after peritoneal dialysis.
In 16 newly diagnosed ESRD patients, total concentrations of adiponectin and high molecular weight (HMW) adiponectin, the HMW ratio (HMWR; ratio of the plasma level of HMW adiponectin to that of total adiponectin), the body mass index (BMI), insulin concentrations, blood glucose and estimation of the insulin sensitivity index by the homeostasis model assessment (HOMR(IR)) were compared before and after 1 year of peritoneal dialysis.
Plasma total adiponectin was decreased from 15.52 +/- 9.35 microg/mL to 11.80 +/- 6.84 microg/mL (P = 0.046), HMW adiponectin was decreased from 9.05 +/- 6.48 microg/mL to 4.83 +/- 4.15 microg/mL (P = 0.009), and HMWR was decreased from 0.51 +/- 0.18 to 0.35 +/- 0.20 (P = 0.008). Total and HMW adiponectin/BMI ratio was decreased. The BMI was increased from 25.2 +/- 5.7 to 25.8 +/- 6.2 (P = 0.036). The HOMR(IR), insulin level and lipid profile were not changed.
Total adiponectin, HMW adiponectin and HMWR were decreased in newly diagnosed ESRD patients after 1 year of peritoneal dialysis. The factors that influence the decrease of the level of adiponectin should be studied in a larger prospective study.
脂联素是一种具有抗动脉粥样硬化作用的脂肪细胞衍生蛋白。血浆脂联素水平与终末期肾病(ESRD)患者的心血管风险呈负相关。本研究旨在阐明新诊断的ESRD患者腹膜透析后脂联素浓度的变化。
对16例新诊断的ESRD患者,比较其腹膜透析1年前和1年后脂联素总浓度、高分子量(HMW)脂联素、HMW比例(HMWR;血浆HMW脂联素水平与总脂联素水平之比)、体重指数(BMI)、胰岛素浓度、血糖以及通过稳态模型评估(HOMR(IR))估算的胰岛素敏感性指数。
血浆脂联素总浓度从15.52±9.35μg/mL降至11.80±6.84μg/mL(P = 0.046),HMW脂联素从9.05±6.48μg/mL降至4.83±4.15μg/mL(P = 0.009),HMWR从0.51±0.18降至0.35±0.20(P = 0.008)。总脂联素和HMW脂联素/BMI比值降低。BMI从25.2±5.7增加至25.8±6.2(P = 0.036)。HOMR(IR)、胰岛素水平和血脂谱未改变。
新诊断的ESRD患者腹膜透析1年后,总脂联素、HMW脂联素和HMWR均降低。脂联素水平降低的影响因素应在更大规模的前瞻性研究中进行探讨。