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慢性肾脏病和高血压性心脏病患者的血清瘦素水平:一项观察性横断面研究。

Serum leptin levels in patients with chronic kidney disease and hypertensive heart disease: An observational cross-sectional study.

作者信息

Ofori Emmanuel K, Adekena Christian N, Boima Vincent, Asare-Anane Henry, Yorke Ernest, Nyarko Eric N Y, Mohammed Bismark N, Quansah Emmanuel, Jayasinghe Sisitha U, Amanquah Seth D

机构信息

Department of Chemical Pathology University of Ghana Medical School Accra Ghana.

University of Ghana Medical Center Accra Ghana.

出版信息

Health Sci Rep. 2023 Jan 19;6(1):e1053. doi: 10.1002/hsr2.1053. eCollection 2023 Jan.

Abstract

BACKGROUND AND AIM

Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD-related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant.

METHODS

An observational cross-sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23.

RESULTS

Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls ( < 0.01 for all). Furthermore, advanced CKD status (being in stage 5), having a 6-year diagnosis of HHD, being female, having a higher BMI, and elevation in levels of HDL and FPG contributed significantly to the variance in serum leptin levels in the case group ( = 0.37, 0.22, 0.19, 0.18, 0.27, 0.28;  < 0.05 for all). In the control group, the female gender had the biggest unique effect on circulating leptin levels, followed by BMI and eGFR ( = 0.71, 0.34, -0.22;  < 0.01 for all).

CONCLUSION

Patients with CKD who also had HHD reported considerably higher circulating leptin levels. Significantly higher blood leptin levels were shown to be associated with CKD stage 5 in the case group. These results are consistent with the role of leptin in the metabolic complexity seen in CKD patients. There needs to be more research into treatments that aim to lower leptin levels in CKD patients with HHD.

摘要

背景与目的

脂肪细胞分泌一种名为瘦素的肽类激素,其在控制食欲和能量消耗方面发挥着关键作用。瘦素浓度的改变与慢性肾脏病(CKD)相关的心血管问题如高血压性心脏病(HHD)有关。尽管存在这种联系,但关于瘦素在CKD和HHD患者中的确切功能的数据却很少。

方法

一项观察性横断面研究,共纳入108名参与者(72例患有HHD的CKD患者和36名健康对照)。使用标准化问卷收集他们的人口统计学和人体测量学信息。评估某些临床指标,如血压和体重指数(BMI)。对空腹血样进行血浆葡萄糖(FPG)、血脂、肌酐和瘦素水平分析。数据用SPSS v23进行分析。

结果

与对照组相比,患有HHD的CKD患者的瘦素、FPG、肌酐和甘油三酯水平均显著更高(所有P均<0.01)。此外,晚期CKD状态(处于5期)、HHD诊断6年、女性、较高的BMI以及HDL和FPG水平升高对病例组血清瘦素水平的差异有显著贡献(R² = 0.37、0.22、0.19、0.18、0.27、0.28;所有P<0.05)。在对照组中,女性对循环瘦素水平的独特影响最大,其次是BMI和估算肾小球滤过率(eGFR)(R² = 0.71、0.34、-0.22;所有P<0.01)。

结论

患有HHD的CKD患者报告的循环瘦素水平明显更高。在病例组中,显著更高的血瘦素水平与CKD 5期相关。这些结果与瘦素在CKD患者所见代谢复杂性中的作用一致。需要对旨在降低患有HHD的CKD患者瘦素水平的治疗方法进行更多研究。

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