Bilen Yusuf, Cankaya Erdem, Bilen Nurhan, Keles Mustafa, Erdem Fuat, Uyanik Abdullah, Hamidullah Uyanik M
Department of Hematology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
Department of Nephrology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
Eurasian J Med. 2014 Oct;46(3):145-50. doi: 10.5152/eajm.2014.45. Epub 2014 Aug 26.
End stage renal disease (ESRD) has a high worldwide prevalence and incidence. Peritonitis is one of the leading causes of hospitalization in peritoneal dialysis patients. Although inflammatory markers show increased inflammatory responses, cellular immune response was decreased in ESRD patients. Leptin is an adipocyte-derived hormone that has activity in energy, nutrition and immune system. Neutrophil to lymphocyte ratio (N/L) was emerged as a predictive and prognostic criterion in many instances. In this study, we aimed to investigate the relationships between increased inflammation in peritoneal dialysis patients and leptin, N/L ratio.
Forty-one ESRD patients, who were been at least 12 months of peritoneal dialysis therapy, were included in the study. Patients' demographic properties were recorded. Serum leptin level, WBC count, C-reactive protein, erythrocyte sedimentation rate and biochemical markers were measured. Patients with active viral or bacterial infection, malignancy, inflammatory disease, immunosuppressive medication users were all excluded from the study. Age and sex-matched healthy control group was included in the study only for their leptin levels.
The measured mean serum leptin level of the patient group was statistically significantly higher than control group (1624.88±1608.16 and 416±439.85). The calculated mean peritonitis incidence was 0.041±0.047 peritonitis/per year. The number of peritonitis attack was significantly correlated with duration of peritoneal dialysis, body mass index (BMI), age and presence of cardiovascular disease. Serum leptin level was significantly correlated with sex, age, primary cause of ESRD, BMI, blood glucose level and duration of peritoneal dialysis (PD).
We detected that ESRD patients have higher serum leptin levels compare to healthy adults. Increased leptin was correlated with sex, age, BMI, primary cause of ESRD and serum glucose level. Number of peritonitis attack and peritonitis incidence was significantly correlated with the duration of PD, BMI and sex. We weren't able to show the predictive N/L value in PD patients in case of peritonitis.
终末期肾病（ESRD）在全球范围内具有较高的患病率和发病率。腹膜炎是腹膜透析患者住院的主要原因之一。尽管炎症标志物显示炎症反应增加，但ESRD患者的细胞免疫反应却有所下降。瘦素是一种由脂肪细胞分泌的激素，在能量、营养和免疫系统中具有活性。中性粒细胞与淋巴细胞比值（N/L）在许多情况下已成为一种预测和预后标准。在本研究中，我们旨在探讨腹膜透析患者炎症增加与瘦素、N/L比值之间的关系。
本研究纳入了41例接受腹膜透析治疗至少12个月的ESRD患者。记录患者的人口统计学特征。测量血清瘦素水平、白细胞计数、C反应蛋白、红细胞沉降率和生化指标。患有活动性病毒或细菌感染、恶性肿瘤、炎症性疾病、使用免疫抑制药物的患者均被排除在研究之外。年龄和性别匹配的健康对照组仅纳入其瘦素水平进行研究。
患者组测得的平均血清瘦素水平在统计学上显著高于对照组（1624.88±1608.16和416±439.85）。计算得出的平均腹膜炎发病率为0.041±0.047次腹膜炎/年。腹膜炎发作次数与腹膜透析持续时间、体重指数（BMI）、年龄和心血管疾病的存在显著相关。血清瘦素水平与性别、年龄、ESRD的主要病因、BMI、血糖水平和腹膜透析（PD）持续时间显著相关。
我们发现ESRD患者的血清瘦素水平高于健康成年人。瘦素升高与性别、年龄、BMI、ESRD的主要病因和血糖水平相关。腹膜炎发作次数和腹膜炎发病率与PD持续时间、BMI和性别显著相关。我们未能在PD患者发生腹膜炎时显示出预测性的N/L值。
