成年囊性纤维化患者的血浆胃饥饿素和瘦素
Plasma ghrelin and leptin in adult cystic fibrosis patients.
作者信息
Cohen Rubin I, Tsang Donna, Koenig Seth, Wilson David, McCloskey Tom, Chandra Subani
机构信息
The Adult Cystic Fibrosis Center, The Division of Pulmonary, Critical Care and Sleep Medicine, The Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
出版信息
J Cyst Fibros. 2008 Sep;7(5):398-402. doi: 10.1016/j.jcf.2008.02.002. Epub 2008 Mar 18.
BACKGROUND
Weight loss in cystic fibrosis (CF) may be associated with altered levels of appetite stimulating peptide ghrelin and the appetite decreasing peptide leptin. However, prior data on leptin in CF are conflicting, while the data on ghrelin are scarce. We hypothesized that weight loss in CF is associated with low levels ghrelin and elevated levels of leptin.
METHODS
Plasma ghrelin, leptin, TNF-alpha, IL-1 and IL-6, BMI, fat free mass (FFM), fat mass (FM) were measured in 74 CF adults and 20 controls. CF subjects were divided into 3 groups based on lung disease: mild (n=19), moderate (n=30) and severe (n=25).
RESULTS
Severe CF patients (% predicted FEV1 27+/-7; median BMI 21 kg/m2) had significantly elevated ghrelin and decreased leptin compared to controls and other CF subjects. Ghrelin correlated (r value, p value) with BMI (-0.35,<0.001), FFM (-0.22,<0.05), FM (-0.41,<0.0001), FEV1 (-0.62,<0.001), TNF-alpha (0.51,<0.0001), IL-1 (0.56,<0.0001), and IL-6 (0.33,<0.01). Leptin correlated (r value, p value) with BMI (0.40,<0.0001), FM (0.56,<0.0001), FEV1 (0.34,<0.05), IL-1 (-0.51,<0.05) and TNF-alpha (-0.43,<0.0001). BMI and FEV1 were independent predictors of ghrelin (-0.35,<0.05;-0.59,<0.001). FM was a predictor of leptin (0.56,<0.0001). Cytokines were elevated only in severe CF (severe CF vs. controls, pg/ml): TNF-alpha (3.4+/-0.6 vs. 1.2+/-0.4), IL-1 (3.5+/-1 vs. 0.2+/-0.1), IL-6 (17.4+/-4 vs. 2.4+/-2).
CONCLUSIONS
Elevated ghrelin and decreased leptin levels are a consequence rather than a cause of weight loss in advanced CF.
背景
囊性纤维化（CF）患者体重减轻可能与刺激食欲的肽类激素胃饥饿素水平改变以及抑制食欲的肽类激素瘦素水平改变有关。然而，既往关于CF患者瘦素的研究数据相互矛盾，而关于胃饥饿素的数据则较为匮乏。我们推测CF患者体重减轻与胃饥饿素水平降低及瘦素水平升高有关。
方法
对74例成年CF患者和20例对照者测定血浆胃饥饿素、瘦素、肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）和白细胞介素-6（IL-6）水平，计算体重指数（BMI）、去脂体重（FFM）和脂肪量（FM）。根据肺部疾病严重程度将CF患者分为3组：轻度（n = 19）、中度（n = 30）和重度（n = 25）。
结果
与对照组和其他CF患者相比，重度CF患者（预计第1秒用力呼气容积（FEV1）为27%±7%；BMI中位数为21kg/m²）的胃饥饿素水平显著升高，瘦素水平降低。胃饥饿素与BMI（r值，p值）（-0.35，<0.001）、FFM（-0.22，<0.05）、FM（-0.41，<0.0001）、FEV1（-0.62，<0.001）、TNF-α（0.51，<0.0001）、IL-1（0.56，<0.0001）和IL-6（0.33，<0.01）相关。瘦素与BMI（0.40，<0.0001）、FM（0.56，<0.0001）、FEV1（0.34，<0.05）、IL-1（-0.51，<0.05）和TNF-α（-0.43，<0.0001）相关。BMI和FEV1是胃饥饿素的独立预测因素（-0.35，<0.05；-0.59，<0.001）。FM是瘦素的预测因素（0.56，<0.0001）。细胞因子仅在重度CF患者中升高（重度CF患者与对照组比较，pg/ml）：TNF-α（3.4±0.6对1.2±0.4）、IL-1（3.5±1对0.2±0.1）、IL-6（17.4±4对2.4±2）。
结论
晚期CF患者胃饥饿素水平升高和瘦素水平降低是体重减轻的结果而非原因。
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