Department of Family Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan.
Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taiwan.
Clin Nutr. 2015 Oct;34(5):943-50. doi: 10.1016/j.clnu.2014.10.001. Epub 2014 Oct 7.
BACKGROUND & AIMS: Higher levels of leptin and homocysteine (Hcy) have been evaluated as risk factors of chronic kidney disease in patients and general population. The aim of this study was to examine gender differences in the associations of leptin and Hcy levels and renal function a representative healthy young population in Taiwan.
The participants aged ≥18 years who underwent health examinations were included and categorized into three groups by gender-specific tertiles of leptin and Hcy levels. Estimated glomerular filtration rates (eGFR) were estimated according to the modified equation of Modification of Diet in Renal Disease (MDRD).
A higher mean Hcy level was found in male subjects than females. Mean values of metabolic syndrome risk factors significantly elevated with increasing leptin levels in both genders. Both male and female subjects with higher plasma Hcy levels were more likely to have a lower eGFR. Plasma Hcy levels were significantly negatively correlated with eGFR in linear regression models adjusted for age and smoking. The associations persisted even after mean arterial pressure and fasting plasma glucose were included for adjustments both genders. Plasma Hcy level was negatively associated eGFR and the association was more profound for females.
Leptin levels did not reveal strong or consistent evidence to support a significant association with eGFR. Hcy had a more decisive effect on renal function impairment than leptin and may be considered a more sensitive biomarker for Taiwanese adults.
已有研究评估了瘦素和同型半胱氨酸（Hcy）水平升高与患者及一般人群慢性肾脏病的相关性，认为其为危险因素。本研究旨在探讨瘦素和 Hcy 水平与肾功能之间的相关性在台湾代表性健康年轻人群中的性别差异。
纳入在健康检查中年龄≥18 岁的参与者，并按性别特异性瘦素和 Hcy 水平三分位将其分为三组。采用改良肾脏病饮食研究（MDRD）方程估算肾小球滤过率（eGFR）。
男性的平均 Hcy 水平高于女性。在两性中，随着瘦素水平的升高，代谢综合征危险因素的平均值显著升高。与 Hcy 水平较低的参与者相比，Hcy 水平较高的男性和女性更有可能出现 eGFR 降低。在校正年龄和吸烟因素后，线性回归模型显示 Hcy 水平与 eGFR 呈显著负相关。即使在调整平均动脉压和空腹血糖后，这种相关性在两性中仍然存在。Hcy 水平与 eGFR 呈负相关，且女性的相关性更为显著。
瘦素水平与 eGFR 之间没有明显的关联，也没有强有力的一致性证据支持这一关联。与瘦素相比，Hcy 对肾功能损害的影响更为显著，因此可作为台湾成年人更敏感的生物标志物。
