慢性肾脏病及透析类型对血清脂联素、肿瘤坏死因子-α和高敏C反应蛋白水平的影响

Effects of chronic kidney disease and type of dialysis on serum levels of adiponectin, TNF-alpha and high sensitive C-reactive protein.

作者信息

Kir Hale Maral, Eraldemir Ceyla, Dervisoglu Erkan, Caglayan Cigdem, Kalender Betul

机构信息

Department of Biochemistry, School of Medicine, Kocaeli University, Kocaeli, Turkey.

出版信息

Clin Lab. 2012;58(5-6):495-500.

PMID:22783580

Abstract

BACKGROUND

In uremic patients, depending on their type, the T-cells produce a range of pro-inflammatory and anti-inflammatory cytokines. The aim of this study was to compare the effects of chronic kidney disease (CKD) and two different therapy methods of dialysis [hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD)] on adiponectin, TNF-alpha, and hs-CRP levels in human serum.

METHODS

We measured the serum levels of hs-CRP, adiponectin, and TNF-alpha in 37 patients with CKD on conservative treatment, 34 patients maintained on CAPD, 35 HD patients, and 25 healthy volunteers. The statistical analysis of the obtained results was performed by commercial statistics PC software.

RESULTS

The mean TNF-alpha levels were found to be significantly higher in patients in the predialysis, CAPD, and the HD groups, than in the control group (17.24 +/- 9.22, 31.57 +/- 10.56, 24.34 +/- 5.32, 7.64 +/- 4.12 pg/mL, respectively, p < 0.001). The mean TNF-alpha levels in the predialysis group were significantly lower than in both the CAPD and the HD group (p < 0.001). The mean TNF-alpha levels in the CAPD group were significantly higher than in the HD group (p = 0.001). The mean adiponectin levels in the control group were significantly lower than in the predialysis, CAPD, and HD groups (2.54 +/- 2.30, 4.10 +/- 3.12, 7.69 +/- 8.35, 5.97 +/- 6.20 ng/mL, respectively, p < 0.05). Furthermore, the mean adiponectin levels in the predialysis groups were significantly lower than in the CAPD group (p < 0.05). The mean hs-CRP levels were found to be significantly higher in patients in the predialysis, CAPD, and HD groups than in the control group (0.65 +/- 0.57, 0.82 +/- 0.71, 1.14 +/- 1.45, 0.30 +/- 0.19 mg/dL, respectively, p < 0.05).

CONCLUSIONS

According to the results of this study, the levels of adiponectin, hs-CRP, and TNF-alpha were increased for all patients with chronic renal failure (CRF). Along with this, the highest level of increase in TNF-alpha levels were observed in patients with CAPD.

摘要

背景

在尿毒症患者中，根据其类型不同，T细胞会产生一系列促炎和抗炎细胞因子。本研究旨在比较慢性肾脏病（CKD）以及两种不同的透析治疗方法[血液透析（HD）和持续性非卧床腹膜透析（CAPD）]对人血清中脂联素、肿瘤坏死因子-α（TNF-α）和高敏C反应蛋白（hs-CRP）水平的影响。

方法

我们测量了37例接受保守治疗的CKD患者、34例接受CAPD治疗的患者、35例HD患者以及25名健康志愿者的血清hs-CRP、脂联素和TNF-α水平。所得结果的统计分析通过商业统计PC软件进行。

结果

发现透析前组、CAPD组和HD组患者的平均TNF-α水平显著高于对照组（分别为17.24±9.22、31.57±10.56、24.34±5.32、7.64±4.12 pg/mL，p<0.001）。透析前组的平均TNF-α水平显著低于CAPD组和HD组（p<0.001）。CAPD组的平均TNF-α水平显著高于HD组（p = 0.001）。对照组的平均脂联素水平显著低于透析前组、CAPD组和HD组（分别为2.54±2.30、4.10±3.12、7.69±8.35、5.97±6.20 ng/mL，p<0.05）。此外，透析前组的平均脂联素水平显著低于CAPD组（p<0.05）。发现透析前组、CAPD组和HD组患者的平均hs-CRP水平显著高于对照组（分别为0.65±0.57、0.82±0.71、1.14±1.45、0.30±0.19 mg/dL，p<0.05）。