HORMONAL REGULATION OF EATING AND ENERGY BALANCE IN CHRONIC RENAL FAILURE

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 慢性肾功能衰竭（CRF）患者容易发生营养不良，这与发病率和死亡率增加有关。 营养不良可能是由于饮食不良或过量的钙。 我们将评估食欲，测量摄食量，同时通过测量代谢率和尿尿素氮排泄量来定量卡他汀。 同时，我们将测量一些已知与饮食和能量消耗有关的激素。 本研究中引入的扰动将包括禁食40小时和重新进食24小时。 将包括四组研究受试者（1）接受血液透析的CRF患者，（2）尚未接受透析的CRF患者，（3）肾移植受试者和（4）正常对照。 待研究的激素分为两类，具有昼夜节律的激素和与膳食相关的激素。 前者包括瘦素、神经肽Y和α促黑素细胞激素，后者包括胆囊收缩素、生长素释放肽和肽YY。 所有测量将在基线状态下进行，禁食40小时，再进食24小时。 将使用DEXA扫描、人体测量和主观总体评估评分评估受试者的总体营养状况。 将通过视觉模拟量表评估食欲。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Patients with chronic renal failure (CRF) are prone to develop malnutrition which is associated with increased morbidity and mortality. Malnutrition could result from either impaired eating or excessive catabolism. We will assess appetite, measure food consumption and at the same time quantitate catabolism by measuring metabolic rate and urinary urea nitrogen excretion. Simultaneously, we will measure a number of hormones known to be related to eating and energy expenditure. The perturbation to be introduced in this study will include 40 hours of fasting and 24 hours of re-feeding. Four groups of study subjects will be included (1) CRF patients on hemodialysis, (2) CRF patients not yet on dialysis, (3) renal transplant subjects and (4) normal controls. The hormones to be studied are divided into two categories, those that have a circadian rhythm and those that are meal-related. The former includes leptin, neuropeptide Y and alpha melanocyte-stimulating hormone, and the latter, cholecystokinin, ghrelin and peptide YY. All the measurements will be done in baseline state, during a 40-hour fast and a 24-hour re-feeding. Overall nutritional status of the subjects will be assessed using DEXA scan, anthropometry and subjective global assessment score. Appetite will be assessed by the visual analogue scale.