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肾移植受者体内脂联素、瘦素、一氧化氮和C反应蛋白水平:与血液透析及慢性肾衰竭患者的比较

Adiponectin, leptin, nitric oxide, and C-reactive protein levels in kidney transplant recipients: comparison with the hemodialysis and chronic renal failure.

作者信息

Ocak Nihal, Dirican Melahat, Ersoy Alparslan, Sarandol Emre

机构信息

a Department of Biochemistry , Faculty of Medicine, Uludag University , Bursa , Turkey.

b Department of Nephrology , Uludag University Medical Faculty , Bursa , Turkey.

出版信息

Ren Fail. 2016 Nov;38(10):1639-1646. doi: 10.1080/0886022X.2016.1229965. Epub 2016 Oct 20.

DOI:10.1080/0886022X.2016.1229965
PMID:27764985
Abstract

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with chronic kidney disease (CKD) including kidney transplant recipients (KTR). Secondary lipid metabolism disorders, endothelial dysfunction, and inflammation enhance the risk of CVD development in these patients. The aim of the present study was to investigate the lipid profile, adiponectin, leptin, nitric oxide (NO), and high sensitivity C-reactive protein (hs-CRP) levels in KTR and to compare these parameters with those of the patients with chronic renal failure (CRF), hemodialysis (HD) patients, and healthy controls.

METHODS

Serum adiponectin and leptin levels were measured by radioimmunoassay; hs-CRP was determined immunoturbidimetrically. Determination of NO was based on the Griess reaction.

RESULTS

Compared with the control group, serum NO and adiponectin levels were significantly higher in the KTR, CRF, and HD groups; hs-CRP levels were significantly higher in the KTR and HD groups; leptin levels were significantly higher in the KTR. In addition, serum NO level was significantly higher in the KTR compared to CRF cases. Adiponectin correlated positively with high density lipoprotein-cholesterol in the control and patient groups. A positive correlation was observed between hs-CRP and NO in the KTR and the patients with CRF. Serum adiponectin levels were inversely correlated with hs-CRP and leptin in the HD group.

CONCLUSION

KTR suffer from inflammation and accompanying changes in levels of adipocytokines and NO which contribute to the increased risk of CVD in these patients.

摘要

背景

心血管疾病(CVD)是慢性肾脏病(CKD)患者(包括肾移植受者(KTR))发病和死亡的主要原因。继发性脂质代谢紊乱、内皮功能障碍和炎症增加了这些患者发生CVD的风险。本研究的目的是调查肾移植受者的血脂谱、脂联素、瘦素、一氧化氮(NO)和高敏C反应蛋白(hs-CRP)水平,并将这些参数与慢性肾衰竭(CRF)患者、血液透析(HD)患者和健康对照者进行比较。

方法

采用放射免疫法测定血清脂联素和瘦素水平;采用免疫比浊法测定hs-CRP。NO的测定基于格里斯反应。

结果

与对照组相比,肾移植受者组、慢性肾衰竭组和血液透析组的血清NO和脂联素水平显著升高;肾移植受者组和血液透析组的hs-CRP水平显著升高;肾移植受者组的瘦素水平显著升高。此外,与慢性肾衰竭患者相比,肾移植受者的血清NO水平显著更高。在对照组和患者组中,脂联素与高密度脂蛋白胆固醇呈正相关。在肾移植受者和慢性肾衰竭患者中,hs-CRP与NO之间存在正相关。在血液透析组中,血清脂联素水平与hs-CRP和瘦素呈负相关。

结论

肾移植受者存在炎症以及脂肪细胞因子和NO水平的伴随变化,这导致这些患者发生心血管疾病的风险增加。

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