Serum immunoreactive leptin concentration and its relation to the body fat content in chronic renal failure.
Serum immunoreactive leptin concentration and its relation to the body fat content in chronic renal failure.
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发表时间：
1997-09
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通讯作者：
O. Heimbürger;Fredrik Lönnqvist;Anders Danielsson;Jorgen Nordenstrom;P. Stenvinkel
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作者：
O. Heimbürger;Fredrik Lönnqvist;Anders Danielsson;Jorgen Nordenstrom;P. Stenvinkel
瘦素由脂肪细胞分泌，通过调节饱腹感信号发挥脂邮作用。瘦素在人类中的作用只被部分揭示。然而，肥胖患者的这种激素水平明显升高，而在正常体重和肥胖受试者中，血清瘦素水平与体脂百分比之间存在直接相关性。本研究的目的是研究瘦素在慢性肾功能衰竭（CRF）中的作用及其与体脂含量的关系，慢性肾功能衰竭是一种与食欲下降相关的疾病。对59例终末期CRF患者（肌酐清除率，8 +/- 1 ml/min）进行血清瘦素水平和体组成（双能x线吸收仪）测定。16例患者在腹膜透析治疗12个月后重新评估，8例患者在血液透析治疗12个月后重新评估。CRF患者的平均血清瘦素浓度（平均+/- SEM）明显高于性别和体重指数匹配的健康对照（25.7 +/- 5.2 ng/ml vs 8.4 +/- 0.9 ng/ml; P 10 mg/L），血清清瘦素水平（41.9 +/- 13.7 ng/ml vs 18.6 +/- 4.2 ng/ml, P < 0.05）高于正常c反应蛋白患者。血清瘦素浓度与体脂率呈显著正相关（rho = 0.83; P < 0.0001）。腹膜透析12个月后，体脂量显著增加（19.0 +/- 1.5 ~ 25.1 +/- 2.2 kg, P < 0.001），血清瘦素浓度变化与体脂含量变化有显著相关性（rho = 0.69, P < 0.01）。相比之下，在血液透析12个月后重新评估的8名患者中，没有记录到体脂含量或血清瘦素水平的显著变化。CRF患者的血清瘦素浓度大约是体重指数相似的健康对照者的三倍。在这项研究中，还证明了血清瘦素是CRF患者体脂含量的良好标记物，并且与腹膜透析12个月期间体脂的变化密切相关。这些发现表明，血清瘦素可以作为CRF患者体脂含量的一个有价值的临床指标。需要进一步的研究来验证血清瘦素浓度升高可能导致尿毒症性厌食症的假设。
Leptin, secreted from fat cells, functions as a lipostat mechanism through modulation of satiety signals. The role of leptin in humans has been only partly revealed. However, obese patients have markedly elevated levels of this hormone, and in both normal-weight and obese subjects there is a direct correlation between serum leptin levels and the percentage of body fat. The aim of the present study was to investigate the role of leptin and its relation to body fat content in chronic renal failure (CRF), a disorder associated with decreased appetite. Serum leptin levels and body composition (dual-energy x-ray absorptiometry) were measured in a cohort of 59 patients with terminal CRF (creatinine clearance rate, 8 +/- 1 ml/min). Sixteen of the patients were re-evaluated after 12 mo of peritoneal dialysis treatment, and eight patients were re-evaluated after 12 mo of hemodialysis treatment. The mean serum leptin concentrations were markedly higher (mean +/- SEM) in patients with CRF than in healthy control subjects matched for gender and body mass index (25.7 +/- 5.2 ng/ml versus 8.4 +/- 0.9 ng/ml; P 10 mg/L) demonstrated higher serum leptin levels (41.9 +/- 13.7 ng/ml versus 18.6 +/- 4.2 ng/ml; P < 0.05) than patients with normal C-reactive protein. A strong positive correlation (rho = 0.83; P < 0.0001) was found between serum leptin concentrations and the percentage of body fat. After 12 mo of peritoneal dialysis, the amount of body fat increased markedly (19.0 +/- 1.5 to 25.1 +/- 2.2 kg; P < 0.001), and the changes in serum leptin concentrations correlated significantly (rho = 0.69; P < 0.01) to the changes in the body fat content. In contrast, no significant changes in either body fat content or serum leptin levels were recorded in the eight patients that were re-evaluated after 12 mo of hemodialysis. Serum leptin concentrations are approximately three times higher in patients with CRF compared with healthy control subjects with a similar body mass index. In this study, it is also demonstrated that serum leptin is a good marker for the body fat content in CRF patients and correlates strongly to changes in body fat during 12 mo of peritoneal dialysis. These findings suggest that serum leptin could serve as a valuable clinical marker for the body fat content in patients with CRF. Further studies are needed to verify the hypothesis that increased serum leptin concentrations may contribute to uremic anorexia.