Oguz Yusuf, Yilmaz Mahmut Ilker, Acikel Cengizhan, Eyileten Tayfun, Caglar Kayser, Oktenli Cagatay, Yenicesu Mujdat, Vural Abdulgaffar
Department of Nephrology, Gulhane School of Medicine, Etlik, Ankara, Turkey.
Ren Fail. 2009;31(1):29-35. doi: 10.1080/08860220802546461.
Adipose tissue appears to be a modulator of vascular injury and systemic inflammation. The aim of this study was to establish the relationship between plasma adiponectin concentration and severity of proteinuria in patients with proteinuria. We enrolled 77 patients with nephrotic and non-nephrotic proteinuria with normal renal function along with 38 matched controls in a cross-sectional study. These patients were divided into group 1 (n = 44, non-nephrotic proteinuria, <3.5 g/day) and group 2 (n = 43, nephrotic proteinuria, >3.5 g/day) by severity of proteinuria. Circulating adiponectin and high-sensitivity C-reactive protein (hsCRP) levels were measured using commercial ELISA. HOMA index and hsCRP levels were all significantly higher in proteinuric patients than in control subjects, while plasma adiponectin levels were significantly lower (p < 0.001). When compared to patients with non-nephrotic proteinuria, patients with nephrotic proteinuria had significantly higher plasma hsCRP and HOMA index (p < 0.001). According to the multiple regression analysis, proteinuria levels were independently related to adiponectin levels. Decreases in adiponectin levels were more prominent in patients with nephrotic proteinuria than in patients with non-nephrotic proteinuria. These results show that the reduction of plasma adiponectin concentrations depend on insulin resistance and inflammation rather than directly severity of proteinuria in patients with proteinuria.
脂肪组织似乎是血管损伤和全身炎症的调节因子。本研究的目的是确定蛋白尿患者血浆脂联素浓度与蛋白尿严重程度之间的关系。在一项横断面研究中，我们纳入了77例肾功能正常的肾病性和非肾病性蛋白尿患者以及38例匹配的对照者。根据蛋白尿的严重程度，这些患者被分为1组（n = 44，非肾病性蛋白尿，<3.5 g/天）和2组（n = 43，肾病性蛋白尿，>3.5 g/天）。使用商用ELISA法测定循环脂联素和高敏C反应蛋白（hsCRP）水平。蛋白尿患者的HOMA指数和hsCRP水平均显著高于对照组，而血浆脂联素水平显著降低（p < 0.001）。与非肾病性蛋白尿患者相比，肾病性蛋白尿患者的血浆hsCRP和HOMA指数显著更高（p < 0.001）。根据多元回归分析，蛋白尿水平与脂联素水平独立相关。肾病性蛋白尿患者脂联素水平的降低比非肾病性蛋白尿患者更为显著。这些结果表明，蛋白尿患者血浆脂联素浓度的降低取决于胰岛素抵抗和炎症，而非直接取决于蛋白尿的严重程度。
