血浆去酰基Ghrelin水平与慢性肾脏病各期的关系

发布时间：2019-06-22 15:41

【摘要】：目的观察慢性肾脏病(CKD)患者及血液透析患者酰基ghrelin(AG)、去酰基ghrelin(DG)水平,并分析其与肾小球滤过率的关系。方法选取46例CKD1-5期患者以及15例血液透析患者。检测测各组身高、体质量、血红蛋白、生化指标、炎症指标以及空腹及餐后、透析后3 h的AG、DG水平,评估食欲及摄食,计算体质量指数(BMI)和肾小球滤过率(eGFR)。结果CKD各期患者BMI及SGA评分无差异,各期患者的食欲、摄食以及营养情况无差异。eGFR随CKD分期的升高而下降,血液透析患者透析充分;与CKD1~2期患者比较,CKD3~5期患者的空腹及餐后DG水平明显升高(P0.01);与CKD各期餐前比较,CKD各期餐后的DG水平明显下降(P0.01);CKD分期与空腹DG(r=0.31,P0.05)、餐后DG(r=0.34,P0.05)、空腹及餐后DG的比例呈正相关(r=0.61,P0.01;r=0.55,P0.01),与TNF-α(r=0.33,P0.05)、IL-6(r=0.40,P0.05)、瘦素(r=0.34,P0.05)、年龄(r=0.41,P0.05)呈正相关;多因素部分相关分析显示,CKD分期与空腹及餐后DG的比例独立相关(r=0.55,P0.01;r=0.43,P0.01);血液透析患者空腹、餐后透前及透析后AG水平无明显差异(P0.05);血液透析患者DG水平餐后透前轻度下降,透析后明显下降(P0.01),低于CKD1~2期患者的餐后水平。多元相关分析显示,空腹及餐后DG与血清白蛋白水平呈负相关(r=-0.64,P0.05;r=-0.59,P0.05),而AG水平与血清白蛋白无相关性。结论 eGFR下降与DG水平负相关;CKD和终末期肾脏病患者餐后ghrelin水平抑制受损;血液透析可使DG水平降至正常。
[Abstract]:Objective to observe the level of acyl ghrelin (AG), deacyl ghrelin (DG) in patients with chronic kidney disease (CKD) and dialysis patients, and to analyze the relationship between acyl ghrelin (AG), deacyl ghrelin (DG) and glomerular filtration rate. Methods 46 patients with CKD1-5 and 15 patients with dialysis were selected. The body height, body mass, hemoglobin, biochemical index, inflammatory index, fasting and postmeal AG,DG levels were measured, appetite and intake were evaluated, body mass index (BMI) and glomerular filtration rate (eGFR).) were calculated. Results there was no difference in BMI and SGA scores among the patients with CKD, and there was no difference in appetite, food intake and nutrition among the patients in each stage. EGFR decreased with the increase of CKD stage and had adequate dialysis in patients with CKD1~2. Compared with patients with CKD1~2 stage, the levels of fasting and postmeal DG in patients with CKD3~5 stage were significantly higher than those in patients with CKD1~2 stage, and the level of DG after meal in each stage of CKD was significantly lower than that in patients with CKD stage (P 0.01). CKD stage was positively correlated with fasting DG (r 鈮，

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