Zhang Honghao, Li Xiujiang, Kan Yanhong, Yang Fan, Hou Yue, DU Yujun
Department of Nephrology, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Intensive Care Unit, Tumor Hospital of Jilin, Changchun, Jilin 130012, P.R. China.
Exp Ther Med. 2015 Nov;10(5):1925-1930. doi: 10.3892/etm.2015.2772. Epub 2015 Sep 23.
Chronic kidney disease (CKD) is commonly accompanied by inflammation and anemia; however, the pathogenesis of CKD is unclear. Expression of resistin, a cysteine-rich secretory plasma protein, is correlated with the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and lipoprotein-associated phospholipase A2, indicating that resistin may be involved in inflammatory events. In addition, inflammation inhibits the activity of erythropoietin (EPO) and, thus, erythropoiesis. The aim of the present study was to analyze the correlation between serum resistin and the variability of EPO responsiveness in CKD patients. The levels of serum creatinine (SCr), C-reactive protein (CRP), total cholesterol, triglycerides, IL-6 and serum resistin were measured in the samples obtained from 138 CKD patients and healthy control subjects. The levels of serum resistin in the CKD groups with and without hemodialysis were significantly higher than those observed in the normal control group (P<0.01) and the levels of serum resistin in the hemodialysis CKD group were higher than those observed in the CKD group without dialysis (P<0.01). The levels of serum resistin in patients in the randomly selected CKD group (with hemodialysis) were positively correlated with the duration of dialysis and the levels of SCr and CRP (P<0.05), however, were negatively correlated with the estimated glomerular filtration rate. The EPO resistance index (ERI) was identified to be associated with body mass index and the levels of CRP and resistin; furthermore, EPO reactivity was correlated with the level of resistin and ERI. The levels of serum resistin were correlated with the variability in EPO responsiveness that was observed in the CKD patients. Therefore, the measurement of serum resistin may aid with understanding the mechanisms, clinical diagnosis and treatment of CKD.
慢性肾脏病(CKD)常伴有炎症和贫血;然而,CKD的发病机制尚不清楚。抵抗素是一种富含半胱氨酸的分泌性血浆蛋白,其表达与肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6和脂蛋白相关磷脂酶A2的表达相关,这表明抵抗素可能参与炎症反应。此外,炎症会抑制促红细胞生成素(EPO)的活性,从而抑制红细胞生成。本研究的目的是分析CKD患者血清抵抗素与EPO反应性变异性之间的相关性。对138例CKD患者和健康对照者的样本进行检测,测定血清肌酐(SCr)、C反应蛋白(CRP)、总胆固醇、甘油三酯、IL-6和血清抵抗素水平。接受和未接受血液透析的CKD组血清抵抗素水平均显著高于正常对照组(P<0.01),且血液透析CKD组血清抵抗素水平高于未透析CKD组(P<0.01)。随机选择的CKD组(接受血液透析)患者的血清抵抗素水平与透析时间、SCr和CRP水平呈正相关(P<0.05),但与估计肾小球滤过率呈负相关。EPO抵抗指数(ERI)与体重指数、CRP和抵抗素水平相关;此外,EPO反应性与抵抗素水平和ERI相关。CKD患者血清抵抗素水平与EPO反应性变异性相关。因此,检测血清抵抗素可能有助于了解CKD的发病机制、临床诊断和治疗。