透析患者队列中的营养不良、炎症和脂质。
Malnutrition, inflammation, and lipids in a cohort of dialysis patients.
机构信息
School of Education, Baylor University, Waco, TX 76798, USA.
出版信息
Postgrad Med. 2010 May;122(3):196-202. doi: 10.3810/pgm.2010.05.2158.
BACKGROUND
This study aimed to determine if there is an association between lipid levels, serum albumin, and C-reactive protein (CRP) levels in patients on dialysis.
METHODS
Lipid profiles, albumin, and CRP levels were collected after a 12-hour fast from patients with end-stage renal disease (N = 105) who were on chronic hemodialysis. Patients were placed in an albumin group (>or= 3.8 g/dL) or a hypoalbumin group (< 3.8 g/dL), a high-risk CRP group (> 3 mg/dL) or a low-risk CRP group (<or= 3 mg/dL), and a low-risk group (low CRP and normal albumin) and high-risk group (high CRP and hypoalbumin). Lipid values included low-density lipoprotein (LDL), LDL particle number, LDL particle size, very-low-density lipoprotein (VLDL), large VLDL, high-density lipoprotein (HDL), large HDL, total cholesterol, lipoprotein A (Lp[a]), and triglycerides. All variables were measured using nuclear magnetic resonance spectroscopy.
RESULTS
Analysis of variance revealed significant differences in the hypoalbumin group, with LDL particle number being lower in this group. Analysis of variance revealed significant differences in LDL, VLDL, and LDL particle number, with lower levels in the high-risk CRP group. Analysis of variance also revealed significant differences in total cholesterol, VLDL, large VLDL, triglycerides, Lp(a), LDL, and LDL particle number when risk was combined with hypoalbumin and high CRP.
CONCLUSIONS
Our study found a counterintuitive effect in LDL and VLDL in patients with high CRP levels, in LDL particle number in patients with low albumin levels, and most variables when patients had both high CRP levels and low levels of albumin.
背景
本研究旨在确定透析患者的血脂水平、血清白蛋白和 C 反应蛋白(CRP)水平之间是否存在关联。
方法
收集了 105 例终末期肾病(ESRD)患者在接受慢性血液透析前禁食 12 小时后的血脂谱、白蛋白和 CRP 水平。将患者分为白蛋白组(>或= 3.8 g/dL)或低白蛋白组(< 3.8 g/dL)、高风险 CRP 组(> 3 mg/dL)或低风险 CRP 组(<或= 3 mg/dL)、低风险组(低 CRP 和正常白蛋白)和高风险组(高 CRP 和低白蛋白)。血脂值包括低密度脂蛋白(LDL)、LDL 颗粒数、LDL 颗粒大小、极低密度脂蛋白(VLDL)、大 VLDL、高密度脂蛋白(HDL)、大 HDL、总胆固醇、脂蛋白 A(Lp[a])和甘油三酯。所有变量均采用核磁共振光谱法测量。
结果
方差分析显示,低白蛋白组 LDL 颗粒数较低,差异有统计学意义。方差分析显示,高风险 CRP 组 LDL、VLDL 和 LDL 颗粒数较低,差异有统计学意义。当风险与低白蛋白和高 CRP 结合时,方差分析还显示总胆固醇、VLDL、大 VLDL、甘油三酯、Lp[a]、LDL 和 LDL 颗粒数存在显著差异。
结论
本研究发现,高 CRP 水平患者的 LDL 和 VLDL 以及低白蛋白水平患者的 LDL 颗粒数存在反直觉的影响,当患者同时存在高 CRP 水平和低白蛋白水平时,大多数变量均存在影响。