Leptin, body composition, and indices of malnutrition in patients on dialysis.
Leptin, body composition, and indices of malnutrition in patients on dialysis.
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发表时间：
1998-06
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通讯作者：
K. Johansen;K. Mulligan;V. Tai;M. Schambelan
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作者：
K. Johansen;K. Mulligan;V. Tai;M. Schambelan
在一组透析患者和对照组中进行了一项横断面研究，以确定瘦素（肥胖（ob）基因的蛋白质产物）血清水平的决定因素。研究了28例透析患者（19例血液透析[HD]患者和9例腹膜透析[PD]患者）和41例健康对照受试者。对于每个受试者，抽取血液用于测量血清瘦素水平，并通过双能X线吸收法分析身体成分。进行回归分析，以确定瘦素水平的预测因子，HD和PD的独立贡献，以及瘦素水平与透析患者营养不良和蛋白质摄入标志物之间的关系。正如预期的那样，在整个组和单独分析的每个亚组中，体脂百分比与瘦素水平密切相关。然而，透析患者的相关性斜率显著大于对照组（P < 0.05）。多变量回归分析显示，即使在调整了年龄、性别和体脂百分比后，HD和PD患者的瘦素水平仍高于对照组。进行单变量分析，以评估瘦素水平和营养状况的标志物，如白蛋白，血尿素氮，蛋白质分解率（PCR），转铁蛋白，胆固醇和瘦体重/身高之间的关系。透析患者血清瘦素水平与血清白蛋白呈显著负相关（r =-0.598，P < 0.001），与PCR呈显著负相关（r =-0.433，P < 0.05）。它的结论是，瘦素水平调整的体脂百分比增加透析患者与对照组相比，特别是在PD。此外，在透析患者中，瘦素水平升高与低血清白蛋白水平和PCR相关。
A cross-sectional study was performed in a group of dialysis patients and control subjects to identify the determinants of serum levels of leptin, the protein product of the obese (ob) gene. Twenty-eight patients on dialysis (19 patients on hemodialysis [HD] and nine patients on peritoneal dialysis [PD]) and 41 healthy control subjects were studied. For each subject, blood was drawn for measurement of serum leptin levels and body composition was analyzed by dual-energy x-ray absorptiometry. Regression analyses were performed to determine the predictors of leptin levels, the independent contribution of HD and PD, and the relationship between leptin levels and markers of malnutrition and protein intake in the patients on dialysis. As expected, percentage of body fat was strongly correlated with leptin levels in the group as a whole and in each subgroup when analyzed separately. However, the slope of the relationship was significantly greater for dialysis patients than for control subjects (P < 0.05). Multivariate regression analysis showed that patients on HD and PD had higher leptin levels than control subjects even after adjustment for age, gender, and percentage of body fat. Univariate analyses were performed to assess the relationship between leptin levels and markers of nutritional status such as albumin, blood urea nitrogen, protein catabolic rate (PCR), transferrin, cholesterol, and lean body mass per height. There was a significant negative correlation between leptin levels and serum albumin (r = -0.598, P < 0.001) and between leptin and PCR (r = -0.433, P < 0.05) in the patients on dialysis. It is concluded that leptin levels adjusted for percentage of body fat are increased in dialysis patients compared with control subjects, particularly in those on PD. In addition, increased leptin levels are associated with low serum albumin levels and PCR in dialysis patients.