Yigit Irem Pembegul, Celiker Huseyin, Dogukan Ayhan, Ilhan Necip, Gurel Ali, Ulu Ramazan, Aygen Bilge
Department of Nephrology, Malatya Government Hospital , Malatya , Turkey .
Ren Fail. 2015 Feb;37(1):77-82. doi: 10.3109/0886022X.2014.975133. Epub 2014 Oct 27.
Neutrophil gelatinase-associated lipocalin (NGAL) is a member of lipocalin family and released from many tissues and cells. We aimed to investigate the relationship among serum NGAL levels, the inflammation markers (IL-6, hs-CRP, TNF-α) and different vascular access types used in dialysis patients.
The study population included 90 patients and 30 healthy age-matched controls. The patients were divided into three groups (I, II, III) and group IV included the controls. In group I and II, the patients were with central venous permanent catheter and arterio-venous fistula, respectively. Group III included 30 patients with chronic renal failure. Hemogram, biochemical assays, ferritin, IL-6, hs-CRP, TNF-α, and NGAL were evaluated in all groups.
Serum NGAL levels were markedly higher in group I than in group II (7645.80 ± 924.61 vs. 4131.20 ± 609.87 pg/mL; p < 0.05). Positive correlation was detected between NGAL levels and duration of catheter (r: 0.903, p: 0.000), hs-CRP (r: 0.796, p: 0.000), IL-6 (r: 0.687, p: 0.000), TNF-α (r: 0.568, p: 0.000) levels and ferritin (r: 0.318, p: 0.001), whereas NGAL levels were negatively correlated with serum albumin levels (r: -0.494, p: 0.000). In multiple regression analysis, duration of catheter hs-CRP and TNF-α were predictors of NGAL in hemodialysis patients.
Inflammation was observed in hemodialysis patients and increases with catheter. Our findings show that a strong relationship among serum NGAL levels, duration of catheter, hs-CRP and TNF-α. NGAL may be used as a new inflammation marker in hemodialysis patients.
中性粒细胞明胶酶相关脂质运载蛋白（NGAL）是脂质运载蛋白家族的一员，可从多种组织和细胞中释放。我们旨在研究透析患者血清NGAL水平、炎症标志物（IL-6、hs-CRP、TNF-α）与不同血管通路类型之间的关系。
研究人群包括90例患者和30例年龄匹配的健康对照。患者分为三组（I、II、III），IV组为对照组。I组和II组患者分别采用中心静脉永久导管和动静脉内瘘。III组包括30例慢性肾衰竭患者。对所有组进行血常规、生化检测、铁蛋白、IL-6、hs-CRP、TNF-α和NGAL评估。
I组血清NGAL水平显著高于II组（7645.80±924.61 vs. 4131.20±609.87 pg/mL；p<0.05）。NGAL水平与导管使用时间（r：0.903，p：0.000）、hs-CRP（r：0.796，p：0.000）、IL-6（r：0.687，p：0.000）、TNF-α（r：0.568，p：0.000）水平及铁蛋白（r：0.318，p：0.001）呈正相关，而NGAL水平与血清白蛋白水平呈负相关（r：-0.494，p：0.000）。多因素回归分析显示，导管使用时间、hs-CRP和TNF-α是血液透析患者NGAL的预测因素。
血液透析患者存在炎症，且随导管使用时间增加。我们的研究结果表明血清NGAL水平、导管使用时间、hs-CRP和TNF-α之间存在密切关系。NGAL可作为血液透析患者新的炎症标志物。
