维持性血液透析患者脂联素与左室肥厚的相关性
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摘要
目的:探讨血清脂联素(APN)、高分子量脂联素(HMW-APN)、高分子量脂联素/脂联素(HMW-APN/APN)在维持性血液透析(MHD)患者中的含量变化及其与左室肥厚的相关性。方法:收集健康对照组30例,慢性肾衰竭未透析患者41例(A组),非糖尿病肾病的MHD患者(B组)31例,糖尿病肾病的MHD患者(C组)33例,抽取静脉血检测;完成超声心动图检查,测量左室质量指数(LVMI)。结果:MHD患者及A组APN、HMW-APN、HMW-APN/APN水平及LVMI均高于健康对照组(P<0.05),MHD患者HMW-APN/APN低于A组(P<0.05),B组HMW-APN/APN高于C组,但差异无统计学意义。行相关性分析发现,MHD患者HMW-APN/APN与体质量指数、甘油三酯、C反应蛋白、LVMI成负相关,与空腹血糖无明显相关性。结论:MHD患者HMW-APN/APN与左室肥厚存在明显相关性,有助于预测心血管事件的发生发展。
Objective: To discuss the relationship among serum adiponectin(APN), high molecular weight of adiponectin(HMW-APN),HMW-APN/APN,and left ventricular mass index(LVMI) in maintenance hemodialysis(MHD) patients. Methods: The study included 135 subjects, 30 of them were healthy subjects and served as the control group, 41 were chronic renal failure(CRF) without MHD patients(group A), 31 were MHD without diabetes mellitus patients(group B), and 33 were MHD with diabetes mellitus patients(group C). Each subject was conducted venous blood test and echocardiography.Results: The levels of serum APN, HMW-APN and HMW-APN/APN were significantly higher in groups A, B, and C than that of healthy controls(P<0.05). Group A had higher HMW-APN/APN than MHD patients(P<0.05). Group B had higher HMW-APN/APN than group C,but there was no statistically significant difference. Correlation analysis found that there was a reverse correlation between Body mass index, triglyceride, C-reactive protein, LVMI and HMW-APN/APNin MHD patients. The levels of HMW-APN/APN were not correlated with fasting blood glucose.Conclusion: In MHD patients, the serum HMW-APN/APN is significantly correlated with the development of LVMI, and is helpful for predicting cardiovascular events.
Objective: To discuss the relationship among serum adiponectin(APN), high molecular weight of adiponectin(HMW-APN),HMW-APN/APN,and left ventricular mass index(LVMI) in maintenance hemodialysis(MHD) patients. Methods: The study included 135 subjects, 30 of them were healthy subjects and served as the control group, 41 were chronic renal failure(CRF) without MHD patients(group A), 31 were MHD without diabetes mellitus patients(group B), and 33 were MHD with diabetes mellitus patients(group C). Each subject was conducted venous blood test and echocardiography.Results: The levels of serum APN, HMW-APN and HMW-APN/APN were significantly higher in groups A, B, and C than that of healthy controls(P<0.05). Group A had higher HMW-APN/APN than MHD patients(P<0.05). Group B had higher HMW-APN/APN than group C,but there was no statistically significant difference. Correlation analysis found that there was a reverse correlation between Body mass index, triglyceride, C-reactive protein, LVMI and HMW-APN/APNin MHD patients. The levels of HMW-APN/APN were not correlated with fasting blood glucose.Conclusion: In MHD patients, the serum HMW-APN/APN is significantly correlated with the development of LVMI, and is helpful for predicting cardiovascular events.
引文
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[14]孙春晓,郭兆安.慢性肾脏病血脂代谢紊乱的影响因素及其机制的研究进展[J].中国中西医结合肾病杂志,2014,15(6):546-548.Sun CX,Guo ZA.Research progress on influencing factors and mechanisms of dyslipidemia in chronic kidney disease[J].Chinese Journal of Integrated Traditional and Western Nephrology,2014,15(6):546-548.
[15]Esfahani M,Movahedian A,Baranchi M,et al.Adiponectin:an adipokine with protective features against metabolic syndrome[J].Iran J Basic Med Sci,2015,18(5):430-442.
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[17]Elokely A,Shoukry A,Ghonemy TA,et al.Association of adiponectin with cardiovascular events in diabetic and non-diabetic hemodialysis patients[J].Saudi J Kidney Dis Transpl,2012,23(4):736-742.
[18]Hu J,Dong J,Yang Z,et al.Protective effects of adiponectin against diabetic renal injury in a mouse model of diabetes[J].Cell Physiol Biochem,2017,43(2):870-878.
[2]Sargolzaei J,Chamani E,Kazemi T,et al.The role of adiponectin and adipolin as anti-inflammatory adipokines in the formation of macrophage foam cells and their association with cardiovascular diseases[J].Clinical Biochemistry,2018,54:1-10.
[3]Iwata M,Hara K,Kamura Y,et al.Ratio of low molecular weight serum adiponectin to the total adiponectin value is associated with type 2 diabetes through its relation to increasing insulin resistance[J].PLoS One,2018,13(3):1-14.
[4]刘爱玲,王志斌,孟媛媛,等.彩色多普勒超声对高血压左心室向心性与离心性心肌肥厚患者左心室舒张功能的评价[J].中国中西医结合影像学杂志,2017,15(3):305-307.Liu AL,Wang ZB,Meng YY,et al.Evaluation of left ventricular diastolic function between concentric and eccentric left ventricular hypertrophy in hypertensive patients using Doppler echocardiography[J].Chinese Imaging Journal of Integrated Traditional and Western Medicine,2017,15(3):305-307.
[5]Trinh E,Chan CT.Intensive home hemodialysis results in regression of left ventricular hypertrophy and better clinical outcomes[J].Am J Nephrol,2016,44(4):300-307.
[6]Yahya RS,Atwa MA,Elsayed IH,et al.Adipocytokines in patients with chronic kidney disease Stage 5[J].Clin Lab,2016,62(1-2):21-30.
[7]Zha D,Wu X,Gao P.Adiponectin and its receptors in diabetic kidney disease:molecular mechanisms and clinical potential[J].Endocrinology,2017,158(7):2 022-2 034.
[8]Cantarin MPM,Waldman SA,Doria C,et al.The adipose tissue production of adiponectin is increased in end-stage renal disease[J].Kidney Int,2013,83(3):487-494.
[9]Kyrou I,Tsantarlioti O,Panagiotakos DB,et al.Adiponectin circulating levels and 10-year(2002-2012)cardiovascular disease incidence:the ATTICA Study[J].Endocrine,2017,58(3):542-552.
[10]Sweiss N,Sharma K.Adiponectin effects on the kidney[J].Best Pract Res Clin Endocrinol Metab,2014,28(1):71-79.
[11]Nowak KL,Chonchol M.Does inflammation affect outcomes in dialysis patients[J]?Semin Dial,2018,31(4):388-397.
[12]Dai L,Golembiewska E,Lindholm B,et al.End-stage renal disease,inflammation and cardiovascular outcomes[J].Contrib Nephrol,2017,191:32-43.
[13]Jaganathan R,Ravindran R,Dhanasekaran S.Emerging role of adipocytokines in type 2 diabetes as mediators of insulin resistance and cardiovascular disease[J].Can J Diabetes,2018,42(4):446-456.
[14]孙春晓,郭兆安.慢性肾脏病血脂代谢紊乱的影响因素及其机制的研究进展[J].中国中西医结合肾病杂志,2014,15(6):546-548.Sun CX,Guo ZA.Research progress on influencing factors and mechanisms of dyslipidemia in chronic kidney disease[J].Chinese Journal of Integrated Traditional and Western Nephrology,2014,15(6):546-548.
[15]Esfahani M,Movahedian A,Baranchi M,et al.Adiponectin:an adipokine with protective features against metabolic syndrome[J].Iran J Basic Med Sci,2015,18(5):430-442.
[16]Koleva DI,Orbetzova MM,Nikolova JG,et al.Pathophysiological role of adiponectin,leptin and asymmetric dimethylarginine in the process of atherosclerosis[J].Folia Medica,2016,58(4):234-240.
[17]Elokely A,Shoukry A,Ghonemy TA,et al.Association of adiponectin with cardiovascular events in diabetic and non-diabetic hemodialysis patients[J].Saudi J Kidney Dis Transpl,2012,23(4):736-742.
[18]Hu J,Dong J,Yang Z,et al.Protective effects of adiponectin against diabetic renal injury in a mouse model of diabetes[J].Cell Physiol Biochem,2017,43(2):870-878.