印度南部一家三级护理医院中，胃饥饿素及其与维持性血液透析患者营养和炎症状态的关联
Ghrelin and its Association with Nutritional and Inflammatory Status of Patients on Maintenance Hemodialysis in a South Indian Tertiary Care Hospital.
作者信息
Vanitha R N, Kavimani S, Soundararajan P, Chamundeeswari D, Kannan G, Rengarajan S
机构信息
Department of Pharmacy Practice, Faculty of Pharmacy, Sri Ramachandra University, Chennai, Tamil Nadu, India.
Department of Pharmacology, Mother Theresa Post Graduate and Research Institute of Health Sciences, Puducherry, India.
出版信息
Ann Med Health Sci Res. 2016 May-Jun;6(3):146-55. doi: 10.4103/2141-9248.183937.
BACKGROUND
Malnutrition and inflammation are associated with morbidity and mortality in patients on maintenance hemodialysis (MHD). Ghrelin, an orexigenic peptide hormone, is speculated to be associated with nutritional and inflammatory status in MHD.
AIM
To assess the serum total ghrelin levels and its possible relationship with inflammation and nutritional status in patients on MHD.
SUBJECTS AND METHODS
The study was conducted on 90 patients on MHD for 6 months and above (56 males, 34 females, mean age 52.6 [11.7] years; mean dialysis vintage 20.9 [12.1] months) and 70 healthy volunteers as control (5 males, 25 females, mean age 50.6 [9.7] years). Demographics were obtained for the study population, and dialysis-related data were collected for cases. Anthropometry, biochemical parameters, serum total ghrelin and inflammatory markers tumor necrosis factor-alpha (TNF-α), and high-sensitivityC-reactive protein (hsCRP) were assessed for cases and control. Self-reported appetite (five questions of appetite and diet assessment tool) and nutritional status (subjective global assessment-dialysis malnutrition score) were assessed for cases.
RESULTS
Ghrelin (242.5 [62.3] pg/mL vs. 80.2 [19.6] pg/mL; P < 0.001), TNF-α (39.8 [15.2] pg/mL vs. 6.5 [1.2] pg/mL; P < 0.001), hsCRP (10.2 [2.8] mg/L vs. 2.7 [0.54] mg/L; P < 0.001) were significantly elevated in cases versus control, anthropometry, and biochemical parameters were significantly decreased in hemodialysis patient. Of 90 cases, (13/90 [14.4%]) were well-nourished, (28/90 [31%]) mild to moderately malnourished, and (49/90 [54.4%]) were moderate to severely malnourished. Appetite was very good for14.4%, good and fair for 47.8%, poor and very poor for 37.8% patients. There was a significant difference in appetite with respect to nutritional status (P < 0.001). Ghrelin had positive correlation with inflammatory markers and negative correlation with nutritional status (P < 0.001).
CONCLUSION
The study identified the association of ghrelin with appetite, nutritional, and inflammatory status of the patients on MHD.
背景
营养不良和炎症与维持性血液透析（MHD）患者的发病率和死亡率相关。胃饥饿素是一种促食欲肽激素，据推测与MHD患者的营养和炎症状态有关。
目的
评估MHD患者的血清总胃饥饿素水平及其与炎症和营养状态的可能关系。
对象与方法
本研究对90例接受MHD治疗6个月及以上的患者（56例男性，34例女性，平均年龄52.6[11.7]岁；平均透析龄20.9[12.1]个月）和70名健康志愿者作为对照（5例男性，25例女性，平均年龄50.6[9.7]岁）进行。获取研究人群的人口统计学资料，并收集病例的透析相关数据。对病例和对照进行人体测量、生化参数、血清总胃饥饿素以及炎症标志物肿瘤坏死因子-α（TNF-α）和高敏C反应蛋白（hsCRP）的评估。对病例进行自我报告的食欲（食欲和饮食评估工具的五个问题）和营养状态（主观全面评估-透析营养不良评分）评估。
结果
与对照组相比，病例组的胃饥饿素（242.5[62.3]pg/mL对80.2[19.6]pg/mL；P<0.001）、TNF-α（39.8[15.2]pg/mL对6.5[1.2]pg/mL；P<0.001）、hsCRP（10.2[2.8]mg/L对2.7[0.54]mg/L；P<0.001）显著升高，血液透析患者的人体测量和生化参数显著降低。90例病例中，（13/90[14.4%]）营养良好，（28/90[31%]）轻度至中度营养不良，（49/90[54.4%]）中度至重度营养不良。14.4%的患者食欲非常好，47.8%的患者食欲良好和一般，37.8%的患者食欲差和非常差。食欲在营养状态方面存在显著差异（P<0.001）。胃饥饿素与炎症标志物呈正相关，与营养状态呈负相关（P<0.001）。
结论
该研究确定了胃饥饿素与MHD患者的食欲、营养和炎症状态之间的关联。
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