Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-001 Szczecin, Poland.
Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-001 Szczecin, Poland.
Nutrients. 2022 Dec 14;14(24):5318. doi: 10.3390/nu14245318.
Hemodialyzed patients with poor erythropoietin response tend to have low volume of visceral adipose tissue and score high on malnutrition-inflammation score. This study investigates in-depth the role of leptin and chosen cytokines in the development of malnutrition-inflammation syndrome (MIS) and erythropoietin resistance.
Eighty-one hemodialyzed patients with erythropoietin-treated anemia were enrolled in the study. Their body composition was measured. Erythropoietin resistance index was calculated. Blood samples for leptin, IL-6, IL-18, TNF-alpha, and IL-1-alpha serum levels were drawn.
Leptin showed negative correlation with erythropoietin resistance index (ERI), whilst IL-6 showed the opposite. IL-6 seemed to be linked more to HD parameters and vintage, while TNF-alpha and leptin were more dependent on body composition. IL-18 and IL-1-alpha did not affect nutritional parameters nor ERI.
Modulation of adipokine- and cytokine-related signaling is a promising target in tempering malnutrition in hemodialyzed, and thus achieving better outcomes in anemia treatment. Large clinical studies that target the inflammatory response in hemodialysis, especially regarding IL-6, TNF-alpha, and leptin, would be of great worth.
促红细胞生成素反应不佳的血液透析患者往往内脏脂肪组织体积较小，营养不良-炎症评分较高。本研究深入探讨了瘦素和选定细胞因子在营养不良-炎症综合征（MIS）和促红细胞生成素抵抗发展中的作用。
本研究纳入了 81 名接受促红细胞生成素治疗贫血的血液透析患者。测量了他们的身体成分。计算了促红细胞生成素抵抗指数。抽取了瘦素、IL-6、IL-18、TNF-α和 IL-1-α血清水平的血液样本。
瘦素与促红细胞生成素抵抗指数（ERI）呈负相关，而 IL-6 则相反。IL-6 似乎与血液透析参数和使用年限更相关，而 TNF-α和瘦素则更多地依赖于身体成分。IL-18 和 IL-1-α既不影响营养参数也不影响 ERI。
调节脂肪因子和细胞因子相关信号是改善血液透析患者营养不良并因此改善贫血治疗结果的有前途的目标。针对血液透析中炎症反应的大型临床研究，特别是针对 IL-6、TNF-α和瘦素的研究，将具有重要价值。
