Kaizu Y, Kimura M, Yoneyama T, Miyaji K, Hibi I, Kumagai H
Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, Yada, Japan.
Am J Kidney Dis. 1998 Jan;31(1):93-100. doi: 10.1053/ajkd.1998.v31.pm9428458.
Studies were performed to investigate the relationship between serum interleukin-6 (IL-6) and the nutritional status in chronic hemodialysis patients. Serum IL-6 in 45 patients (21 men and 24 women), each with chronic renal failure and having undergone hemodialysis for more than 3 years, was measured before and after a dialysis session. The nutritional status of each patient was evaluated by measuring body mass index (BMI), body weight loss for 3 years, midarm muscle area (MAMA), serum albumin, prealbumin, and insulin-like growth factor-1. Serum IL-6 was significantly higher in the patients undergoing hemodialysis (11.7 +/- 2.8 pg/mL) than in healthy volunteers (< 0.6 pg/mL). There was no further increase in serum IL-6 after a dialysis session when the extracellular water volume was corrected by the ultrafiltrate volume. Predialytic serum IL-6 was significantly correlated with serum albumin (r = -0.4, P = 0.006), cholinesterase (r = -0.51, P = 0.001), body weight change for 3 years (r = -0.48, P = 0.001) and MAMA r = -0.39, P = 0.05). With the patients divided into two groups, a high serum IL-6 (>10 pg/mL) group and low serum IL-6 (<10 pg/mL) group, the body weight loss for 3 years (-4.60% +/- 1.39% v 0.76 +/- 0.75%, P < 0.01) was significantly higher, and the serum albumin level (3.66 +/- 0.10 g/dL v 3.96 +/- 0.05 g/dL, P < 0.05) was significantly lower in those patients with high serum IL-6 than in those with low serum IL-6. The results of a multiple regression analysis indicated that the serum IL-6 level was dependent on the duration of hemodialysis, age, and the dialysis membrane properties. These results suggest that the nutritional status in chronic hemodialysis patients was affected, at least in part, by the circulating IL-6 level. Multiple factors, such as long-term hemodialysis, aging, and the use of a regenerated cellulose membrane dialyzer, were associated with this increased level of IL-6.
开展了多项研究以调查慢性血液透析患者血清白细胞介素-6（IL-6）与营养状况之间的关系。对45例（21例男性和24例女性）慢性肾衰竭且已接受血液透析3年以上的患者，在透析治疗前后测定其血清IL-6水平。通过测量体重指数（BMI）、3年体重减轻情况、上臂中部肌肉面积（MAMA）、血清白蛋白、前白蛋白和胰岛素样生长因子-1来评估每位患者的营养状况。接受血液透析的患者血清IL-6水平（11.7±2.8 pg/mL）显著高于健康志愿者（<0.6 pg/mL）。当通过超滤量校正细胞外液量后，透析治疗后血清IL-6水平未进一步升高。透析前血清IL-6与血清白蛋白（r = -0.4，P = 0.006）、胆碱酯酶（r = -0.51，P = 0.001）、3年体重变化（r = -0.48，P = 0.001）和MAMA（r = -0.39，P = 0.05）显著相关。将患者分为两组，即高血清IL-6（>10 pg/mL）组和低血清IL-6（<10 pg/mL）组，高血清IL-6组患者的3年体重减轻幅度（-4.60%±1.39%对0.76±0.75%，P<0.01）显著更高，血清白蛋白水平（3.66±0.10 g/dL对3.96±0.05 g/dL，P<0.05）显著更低。多元回归分析结果表明，血清IL-6水平取决于血液透析时长、年龄和透析膜特性。这些结果提示，慢性血液透析患者的营养状况至少部分受到循环IL-6水平的影响。多种因素，如长期血液透析、衰老以及使用再生纤维素膜透析器，均与这种IL-6水平升高有关。
