单纯性肥胖患者血清脂联素、血清瘦素与肾损伤的相关性分析

2016-04-21赵菊兰李艳伟天津医科大学第二医院肾内科天津300211

天津医科大学学报 2016年1期

赵菊兰，夏　天，李　荣，李艳伟（天津医科大学第二医院肾内科，天津　300211）

赵菊兰，夏天，李荣，李艳伟
（天津医科大学第二医院肾内科，天津300211）

摘要目的：研究单纯性肥胖患者血清脂联素、血清瘦素与尿白蛋白、肾小球滤过率相关性及两种脂肪因子对肾脏的作用。方法：选取单纯肥胖患者（肥胖组）60例，同期健康人（对照组）40例，测定两组人群血清脂联素、血清瘦素、身高、体质量、肾功能及尿白蛋白等，计算两组人群瘦素与脂联素比值、体质量指数（BMI）及肾小球滤过率（GFR）。结果：肥胖组血清脂联素明显低于对照组（P<0.001）；肥胖组血清瘦素明显高于对照组（P<0.001）；肥胖组较对照组尿白蛋白差异明显（P=0.004）；肥胖组血清瘦素/脂联素与对照组差异明显（P<0.001）；脂联素与BMI、尿白蛋白为负相关（r分别为：-0.421、-0.245；P分别为<0.001、0.029）；血清瘦素与BMI正相关（r=0.650，P<0.001），与GFR负相关（r=-0.227，P=0.043）；瘦素/脂联素与BMI正相关（r=0.511，P<0.001）；GFR与BMI正相关（r=0.376，P=0.001）；瘦素、瘦素/脂联素、BMI与尿白蛋白无相关性；脂联素、瘦素/脂联素与GFR无相关性。结论：单纯性肥胖患者血清脂联素水平下降，血清瘦素、尿白蛋白水平升高。瘦素/脂联素比值可能是单纯性肥胖患者肾损伤预后的预测因子。

关键词肥胖；脂联素；瘦素；尿白蛋白；肾小球滤过率；体质量指数；瘦素/脂联素

Correlation analysis of serum adiponectin and serum leptin to renal damage in patients with simply obesity

ZHAO Ju-lan,XIA Tian,LI Rong,LI Yan-wei
（Department of Nephrology,The Second Hospital，Tianjin Medical University，Tianjin 300211，China）

Abstract Objective:To analyze the correlation among urinary albumin,glomerular filtration rate and two factors,serum adiponectin and serum leptin in patients with simple obesity.And to explore the impact of these two factors in patients with simple obesity on kidney.Methods:Sixty patients with simple obesity（obese group）and forty healthy people（control group）were included.Their height,weight,renal function and urinary albumin were measured.Their body mass index（BMI）and glomerular filtration rate（GFR）were calculated.The levels of serum adiponectin and serum leptin were detected by radioimmunoassay.Results:The level of serum adiponectin in obese group was lower than control group（P<0.001）.The levels of serum leptin and urinary albumin of obese group were higher than control group （P<0.001,P=0.004）.The ratio of leptin/adiponectin was significantly different between the two groups（P<0.001）.The level of serum adiponectin was negatively correlated with BMI（r=-0.421,P<0.001）and urinary albumin（r=-0.245,P=0.029）.The level of serum leptin was positively correlated with BMI（r=0.650,P<0.001）and negatively correlated with GFR（r=-0.227,P=0.043）.BMI was positively correlated with GFR（r=0.376,P=0.001）and leptin/adiponectin ratio（r=0.511,P<0.001）.No correlation was found between the urinary albumin and BMI,serum leptin,leptin/adiponectin ratio.No correlation was found between GFR and serum adiponectin,leptin/adiponectin ratio.Conclusion:Obesity could lead to a decrease in serum adiponectin level and an increase in serum leptin and urinary albumin.These findings suggest that ratio of leptin/adiponectin may be predict ive factor for renal injury in patients with simple obesity.

Key words obesity；serumadiponectin；serumleptin；urinaryalbumin；glomerularfiltrationrate；bodymassindex；leptin/adiponectinratio

目前肥胖及超重已经成为全球性的公共卫生问题，随着我国经济的发展及膳食结构和生活方式的改变，我国肥胖人数较前明显增加，与肥胖相关的疾病发病率也呈快速增长态势，其中肥胖对于肾脏的损伤越来越成为研究的热点。已有大量研究证实，肥胖会导致蛋白尿的发生及肾脏损害[1]，即肥胖相关性肾病（ORG）。脂联素及瘦素为脂肪细胞分泌的蛋白质，本研究旨在分析单纯性肥胖患者血清脂联素、血清瘦素水平变化及其与尿白蛋白、肾小球滤过率（GFR）之间的关系，探讨两种脂肪因子在ORG发生、发展中的作用以及在预测ORG预后的临床价值。