Department of Endocrinology, University Clinical Center of the Republic of Srpska, 12 babies nn, Banja Luka, Bosnia and Herzegovina.
Faculty of Medicine, University of Banja Luka, Save Mrkalja 14, Banja Luka, Bosnia and Herzegovina.
Rom J Intern Med. 2021 May 8;59(2):187-193. doi: 10.2478/rjim-2021-0002. Print 2021 Jun 1.
Hemodialysis (HD) patients have higher mortality rate than the general population. Recent studies indicate a significant role of non-cardiovascular risk factors in for mortality in HD patients. Leptin is protein hormone and may indicate malnutrition in HD patients. Its role in mortality in these patients is being examined. This study aimed to investigate the correlation between serum leptin levels and non-cardiovascular risk factors and relationship between leptin level and mortality in HD patients. The prospective study included 93 patients on maintenance HD and follow-up period was 12 months. We measured leptin level and evaluated non-cardiovascular risk factors: nutritional status, anemia, volemia, parameters of mineral and bone disorder. Out of 93 patients 9 died during study and 1 underwent kidney transplantation. Malnutrition and hypervolemia were two main non-cardiovascular risk factors among deceased subjects. Leptin showed a significant direct correlation with nutritional BMI (r = 0.72, < 0.001), fat tissue index (r = 0.74, < 0.001) and statistically significant inverse correlation with leantissue index (r = -0.349, < 0.05) and inverse correlation with volemic parameters (overhydration / extracellular water ratio (r = -0.38, < 0.001), but no association with anemia and mineral bone parameters was observed. Elevated leptin levels were associated with better survival. However, no statistically significant difference in survival rates was observed between the study groups (Log-Rank =0.214, Breslow =0.211, Tarone-Ware =0.212). Deceased patients had significantly lower leptin values. Leptin was associated with two non-cardiovascular risk factors for mortality: malnutrition and hypervolemia.
血液透析（HD）患者的死亡率高于普通人群。最近的研究表明，非心血管危险因素在 HD 患者的死亡率中起着重要作用。瘦素是一种蛋白质激素，可能表明 HD 患者存在营养不良。目前正在研究其在这些患者中的死亡率作用。本研究旨在探讨血清瘦素水平与非心血管危险因素的相关性，以及瘦素水平与 HD 患者死亡率的关系。这项前瞻性研究纳入了 93 名维持性 HD 患者，随访时间为 12 个月。我们测量了瘦素水平，并评估了非心血管危险因素：营养状况、贫血、血容量、矿物质和骨代谢紊乱参数。在 93 名患者中，有 9 名在研究期间死亡，1 名接受了肾移植。营养不良和血容量过多是死亡患者的两个主要非心血管危险因素。瘦素与营养 BMI（r = 0.72，<0.001）、脂肪组织指数（r = 0.74，<0.001）呈显著正相关，与 lean 组织指数（r = -0.349，<0.05）呈显著负相关，与血容量参数呈负相关（超容量/细胞外液比（r = -0.38，<0.001），但与贫血和矿物质骨参数无相关性。较高的瘦素水平与更好的生存相关。然而，研究组之间的生存率无统计学差异（Log-Rank =0.214，Breslow =0.211，Tarone-Ware =0.212）。死亡患者的瘦素值明显较低。瘦素与两个非心血管死亡危险因素相关：营养不良和血容量过多。
