Clinical Nutrition Department, Nutrition Faculty, Federal University Fluminense, Niterói, Brazil.
Nutrition. 2010 Nov-Dec;26(11-12):1100-4. doi: 10.1016/j.nut.2009.09.003. Epub 2009 Dec 16.
Compounds involved in the regulation of appetite and body composition appear to be of interest in chronic kidney disease. The purpose of this study was to analyze plasma obestatin and acyl and des-acyl ghrelin in patients on hemodialysis (HD).
Fifty patients on HD (56.0% women, mean age 62.2 ± 15.2 y) were studied. Blood samples were collected during fasting, before a regular HD session. Serum acyl and des-acyl ghrelin levels, leptin, and obestatin were measured using enzyme immunometric assay methods. Anthropometric parameters, appetite score, and food intake were recorded.
Patients showed elevated serum leptin (34.1 ± 30 ng/mL), normal acyl ghrelin (137 ± 116.5 pg/mL), high des-acyl ghrelin (670 ± 479 pg/mL), and low obestatin (2.0 ± 1.4 ng/mL) levels compared with healthy volunteers. According to body mass index (BMI), patients with a BMI >23 kg/m(2) had significantly lower plasma obestatin. In contrast, leptin levels were increased and acyl ghrelin tended to be higher in these patients. There was a strong positive correlation between obestatin and des-acyl ghrelin (r = 0.56, P = 0.0001) and inverse correlations between obestatin and BMI (r = -0.40, P = 0.007), waist circumference (r = -0.38, P = 0.024), and C-reactive protein (r = -0.29, P = 0.048). By multivariate analysis, obestatin was independently and positively correlated with des-acyl ghrelin (P = 0.01), but not with C-reactive protein, BMI, or waist circumference.
In summary, patients on HD exhibited increased plasma levels of des-acyl ghrelin, normal acyl ghrelin levels, and low obestatin levels. In lean patients, the obestatin and des-acyl ghrelin levels were increased, suggesting that these hormones may influence appetite and body composition in patients on HD.
参与食欲和身体成分调节的化合物似乎对慢性肾脏病有研究意义。本研究旨在分析血液透析（HD）患者的血浆脑肠肽和酰基及去酰基胃饥饿素。
研究了 50 名 HD 患者（56.0%为女性，平均年龄 62.2±15.2 岁）。空腹时采集血液样本，在常规 HD 治疗前采集。使用酶免疫测定法检测血清酰基和去酰基胃饥饿素、瘦素和脑肠肽水平。记录人体测量参数、食欲评分和食物摄入量。
与健康志愿者相比，患者的血清瘦素（34.1±30ng/mL）升高，酰基胃饥饿素（137±116.5pg/mL）正常，去酰基胃饥饿素（670±479pg/mL）升高，脑肠肽（2.0±1.4ng/mL）降低。根据体重指数（BMI），BMI＞23kg/m2的患者血浆脑肠肽水平明显降低。相反，这些患者的瘦素水平升高，酰基胃饥饿素水平升高。脑肠肽与去酰基胃饥饿素呈强正相关（r=0.56，P=0.0001），与 BMI（r=-0.40，P=0.007）、腰围（r=-0.38，P=0.024）和 C 反应蛋白（r=-0.29，P=0.048）呈负相关。多元分析显示，脑肠肽与去酰基胃饥饿素呈独立正相关（P=0.01），与 C 反应蛋白、BMI 或腰围无关。
总之，HD 患者表现出升高的血浆去酰基胃饥饿素、正常的酰基胃饥饿素水平和降低的脑肠肽水平。在瘦患者中，脑肠肽和去酰基胃饥饿素水平升高，表明这些激素可能影响 HD 患者的食欲和身体成分。
