Relative contributions of inflammation and inadequate protein intake to hypoalbuminemia in patients on maintenance hemodialysis.
Relative contributions of inflammation and inadequate protein intake to hypoalbuminemia in patients on maintenance hemodialysis.
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DOI：
10.1007/s11255-012-0170-8
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发表时间：
2013-02
影响因子：
2
通讯作者：
Kalantar-Zadeh, Kamyar
中科院分区：
文献类型：
--
作者：
Kim, Youngmee;Molnar, Miklos Z.;Rattanasompattikul, Manoch;Hatamizadeh, Parta;Benner, Debbie;Kopple, Joel D.;Kovesdy, Csaba P.;Kalantar-Zadeh, Kamyar
关键词：
血清白蛋白是维持性血液透析（MHD）患者最强的死亡率预测因子之一。然而，血清白蛋白在多大程度上代表膳食蛋白质摄入或炎症状态等尚不清楚。我们假设这些蛋白质摄入不足和炎症在某种程度上同样导致了低白蛋白血症。在横断面分析中，我们检测了812名MHD患者的低血清白蛋白（<3.8 g/dL）的相关性，这些患者也测量了白细胞介素-6 （IL-6）和正常化蛋白氮外观（nPNA），也称为正常化蛋白分解代谢率（nPCR）。采用Logistic回归估计比值比，并绘制样条模型来检验血清白蛋白<3.8 g/dL相对较低的可能性。患者平均年龄（±SD）为54±15岁；53%的患者为男性，50%为西班牙裔，31%为非裔美国人，55%为糖尿病患者。平均透析时间为31±34个月（中位数：19个月，四分位数间距：7-44个月）。基线血清白蛋白，3个月期间平均值（平均值±SD）为3.88±0.38 g/mL。IL-6和nPNA与血清白蛋白的未校正相关系数分别为- 0.36和+0.20 （p < 0.001）。白蛋白<3.8克/分升的可能性随着nPNA的降低和血清IL-6的升高而线性增加。随着血清IL-6浓度增加至30 ng/mL，这一趋势更为陡峭。低蛋白摄入和高炎症状态与MHD患者的低血清白蛋白有关。
Serum albumin is one of the strongest mortality predictors in maintenance hemodialysis (MHD) patients. Yet, the degree to which serum albumin represents dietary protein intake or an inflammatory state, among others, is not clear. We hypothesize that these inadequate protein intake and inflammation contribute somewhat equally to hypoalbuminemia. In a cross-sectional analysis, we examined correlates of low serum albumin, <3.8 g/dL, in 812 MHD patients in whom interleukin-6 (IL-6) and normalized protein nitrogen appearance (nPNA), also known as normalized protein catabolic rate (nPCR), were also measured. Logistic regression estimated odds ratios were employed, and spline models were plotted to examine the likelihood of relatively low serum albumin <3.8 g/dL. Mean age (±SD) of patients was 54 ± 15 years; 53 % of patients were men, 50 % Hispanic, 31 % African–American, and 55 % diabetic. The mean dialysis vintage was 31 ± 34 months (median: 19, inter-quartile range: 7–44 months). The baseline serum albumin, averaged over a 3-month period (mean ± SD), was 3.88 ± 0.38 g/mL. The unadjusted correlation coefficients of l IL-6 and nPNA with serum albumin were −0.36 and +0.20, respectively (p < 0.001 for each comparison). The likelihood for an albumin <3.8 gr/dL increased linearly with decreasing nPNA and rising serum IL-6. This trend was steeper with increasing serum IL-6 up to a concentration of 30 ng/mL. Both low protein intakes and a high state of inflammation are associated with low serum albumin in MHD patients.
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影响因子：
19.6
作者：
Balakrishnan, VS;Guo, DQ;Pereira, BJG
通讯作者：
Pereira, BJG
影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
影响因子：
6.1
作者：
Kalantar-Zadeh, K;Dunne, E;Luft, FC
通讯作者：
Luft, FC
影响因子：
19.6
作者：
KAYSEN, GA;GAMBERTOGLIO, J;HUTCHISON, FN
通讯作者：
HUTCHISON, FN
影响因子：
6.1
作者：
Kopple, Joel D.;Cheung, Alfred K.;Ikizler, Talat Alp
通讯作者：
Ikizler, Talat Alp