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Hemodiyaliz Hastalarında Leptin Parametreleri Enflamasyon ve Protein- Enerji Kaybının Serum ve Antropometrik Göstergeleri ile İlişkilidir

Leptin Parameters are Associated with Inflammation and Both Anthropometric and Serum Markers of Protein-Energy Wasting in Hemodialysis Patients

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DOI: 
10.5262/tndt.2014.1002.02
Abstract (2. Language): 
OBJECTIVE: Protein-energy wasting (PEW) and inflammation are common and related to increased cardiovascular mortality in hemodialysis (HD) patients. Herein, we aimed to investigate the relationships between adipocytokines, inflammation and serum and anthropometric markers of PEW syndrome in HD patients. MATER IAL and MET HODS : Seventy-four HD patients (mean age=62±13 years, male/female=44/30) were enrolled. Serum leptin, adiponectin and IL-6 levels were measured by ELISA. Anthropometric measurements such as triceps skin fold thickness (TSFT), mid-arm circumference (MAC) were performed. Bioelectrical impedance analysis was also done. The degree of malnutrition was evaluated with subjective global assessment (SGA). RESULTS : The leptin/fat ratio was associated with serum IL-6 (r=0.32, p=0.008), serum albumin (r= -0.37, p=0.002) and TSFT (r= -0.41, p=0.001). Serum adiponectin levels were positively correlated with serum albumin (r=0.29,p=0.01) and negatively associated with the leptin/fat ratio (r= -0.30, p=0.01). Serum CRP levels were significantly lower in the high adiponectin group (1.20 ±0.92 vs 2.02 ±2.18 μg/mL, p=0.042). On linear regression analysis for predicting the leptin/fat ratio, gender and serum albumin were retained as significant in the model. CONCLUS ION: Serum leptin parameters are associated with inflammation and both anthropometric and serum markers of protein-energy wasting. Adipocytokines may be the link between PEW and inflammation in uremia.
Abstract (Original Language): 
AMAÇ: Hemodiyaliz (HD) hastalarında protein-enerji kaybı (PEK) ve enflamasyon yaygındır ve artmış kardiyovasküler mortalite ile yakından ilişkilidir. Bu çalışmada, HD hastalarında adipokinler ile enflamasyon ve serum ile PEK sendromunun antropometrik göstergeleri arasındaki ilişkinin araştırılması amaçlanmıştır. GERE Ç ve YÖNTEMLER : Çalışmaya 74 HD hastası (ortalama yaş= 62+13, erkek/kadın oranı 44/30) alındı. Serum leptin, adiponektin ve IL-6 seviyeleri ELISA ile ölçüldü. Triseps deri kıvrım kalınlığı (TSFT), orta kol çevresi (MAC) gibi antropometrik ölçümler yapıldı. Ayrıca biyoelektrik impedans analizi yapıldı. Malnütrisyon derecesi subjektif global değerlendirme (SGA) testi ile değerlendirildi. BUL GUL AR: Leptin / yağ oranının serum IL-6 (r=0,32, p=0,008) ve serum albumin (r= -0,37, p=0,002) seviyeleri ve TSFT (r= -0,41, p=0,001) ile ilişkili olduğu görüldü. Serum adiponektin düzeyleri serum albumini (r=0,29, p=0,01) ile pozitif korele ve leptin/yağ oranı (r= -0,30, p=0,01) ile negatif korele bulundu. Yüksek adiponektin düzeyi olan grupta serum CRP düzeyleri anlamlı olarak düşük bulundu (1,20 ± 0,92 vs 2,02 ± 2,18 μg/mL, p=0,042). Modelde leptin /yağ oranının prediktif değeri için yapılan lineer regresyon analizinde cinsiyet ve serum albümin değeri anlamlı kalmaya devam etti.SONU Ç: Serum leptin parametreleri hem enflamasyon ile hem de PEK’in antropometrik ve serum göstergeleri ile ilişkilidir. Adipositokinler, üremik hastalarda, enflamasyon ve PEK arasındaki bağlantı olabilir.
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