Hsu B-G, Shih M-H, Yang Y-C, Ho G-J, Lee M-C
School of Medicine, Tzu Chi University, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Transplant Proc. 2012 Apr;44(3):646-50. doi: 10.1016/j.transproceed.2011.11.008.
The metabolic syndrome (MetS) is a risk factor for posttransplant diabetes mellitus, chronic graft dysfunction, graft loss, occurrence of atherosclerotic events, and patient death among kidney transplantation patients. Long-acting natriuretic peptide (LANP) is among the peptide hormones in atrial natriuretic peptide prohormone. Low levels of natriuretic peptide may lead to reduced lipolysis and excessive weight gain in obese patients. This study was undertaken to evaluate the relationship between MetS and fasting serum LANP concentration among kidney transplanted patients. Fasting blood samples were obtained from 69 kidney recipients. The MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation. Fasting LANP levels were measured using a commercial enzyme immunoassay kit. The prevalence rate of MetS was 20.3% (14/69). Fasting LANP level negatively correlated with MetS among these patients (P = .010). Using univariate linear regression analysis, serum LANP values were negatively correlated with hemoglobin (r = -0.252; P = .037), and positively correlated with blood urea nitrogen (r = 0.254; P = .035) and creatinine (r = 0.311; P = .009). Multivariate forward stepwise linear regression analysis of the significant variables revealed that creatinine (R(2) change = 0.097; P = .009) was an independent predictor of fasting serum LANP concentration among kidney transplanted patients. Serum LANP concentration correlates inversely with MetS; for these patients, creatinine is an independent predictor of the serum LANP value.
代谢综合征(MetS)是肾移植患者发生移植后糖尿病、慢性移植物功能障碍、移植物丢失、动脉粥样硬化事件及患者死亡的危险因素。长效利钠肽(LANP)是心房利钠肽原激素中的一种肽类激素。利钠肽水平低可能导致肥胖患者脂肪分解减少和体重过度增加。本研究旨在评估肾移植患者中MetS与空腹血清LANP浓度之间的关系。从69例肾移植受者中采集空腹血样。采用国际糖尿病联盟的诊断标准定义MetS及其组分。使用商用酶免疫分析试剂盒测量空腹LANP水平。MetS的患病率为20.3%(14/69)。在这些患者中,空腹LANP水平与MetS呈负相关(P = 0.010)。采用单变量线性回归分析,血清LANP值与血红蛋白呈负相关(r = -0.252;P = 0.037),与血尿素氮呈正相关(r = 0.254;P = 0.035),与肌酐呈正相关(r = 0.311;P = 0.009)。对显著变量进行多变量向前逐步线性回归分析显示,肌酐(R(2)变化 = 0.097;P = 0.009)是肾移植患者空腹血清LANP浓度的独立预测因子。血清LANP浓度与MetS呈负相关;对于这些患者,肌酐是血清LANP值的独立预测因子。