肝硬化患者血清瘦素水平与营养状态的关系  

Serum leptin levels in patients with liver cirrhosis and the relationship to their nutritional status

作　　者：何池义[1] 刘少锋[1] 张国政[1] 章顺国[1] 袁鹤鸣[1] 杨军[2] 韩真[1] 

机构地区：[1]皖南医学院附属弋矶山医院消化科,安徽芜湖241001 [2]皖南医学院附属弋矶山医院核医学科,安徽芜湖241001

出　　处：《皖南医学院学报》2004年第4期256-258,共3页Journal of Wannan Medical College

基　　金：皖南医学院中青年科研基金项目 (WK2 0 0 3 2 2B)

摘　　要：目的　研究肝硬化患者血清瘦素水平的变化及其与营养状态的关系。方法　选择肝硬化患者 35例 (男 2 7例 ,女 9例 )及健康人 30例 (男 2 0例 ,女 10例 ) ,于清晨空腹取血 ,应用放射免疫分析法测定血清瘦素水平 ;同时检测受试者总蛋白、白蛋白、前白蛋白、身高、体重和肱三头肌皮褶厚度等 ,按体重 (kg) / [身高 (m) ]2 计算体质指数。结果　肝硬化患者血清瘦素水平 [(6 .5 6± 3.32 )ng/ml]明显高于对照组 [(4.39± 2 .11)ng/ml],并有性别依赖性 ;当所有参试者一起评估时 ,血清瘦素水平与BMI、TSF呈显著相关 (r =0 .38,P =0 .0 15 ;r =0 .5 9,P =0 .0 31) ,血清瘦素水平与总蛋白、白蛋白、前白蛋白无相关性 (P >0 .0 5 )。但肝硬化组单独评估时 ,血清瘦素水平与TSF显著相关 (r =0 .6 1,P =0 .0 2 7) ,血清瘦素水平与BMI则无显著相关性 (r =0 .34,P =0 .11) ,血清瘦素水平与总蛋白、白蛋白、前白蛋白均无显著相关性 (P >0 .0 5 )。结论　肝硬化患者血清瘦素水平明显升高 ,女性的瘦素水平高于男性 ,其浓度与TSF呈正相关 ,血清瘦素含量可以反映肝硬化患者的营养状况 ,尤其是脂肪营养状况。Objective To detect the leptin levels in patients with liver cirrhosis and the relationship to their nutritional status. Methods 35 patients with liver cirrhosis (M/F: 26/9) and 30 controlled healthy subjects (M/F: 20/10) were enlisted in the study. Blood was drawn after an overnight fast. Serum leptin was measured by using a human leptin RIA kit; Other testing measurements such as blood tests to measure total protein(TP),albumin(ALB),prealbumin(PA),the height,body weight and triceps skinfold (TSF) of candidates were measured simultaneously. Body Mass index (BMI) matched body weight (kg)/[height(m)]+2. Results The mean serum levels were (6.56±3.32)ng/ml in liver cirrhosis and (4.39±2.11)ng/ml in the control group. Mean serum leptin level was significantly higher in the liver cirrhosis group than that in the control group. Compared with those in male subjects,leptin levels in female subjects increased in healthy controls and patients with liver cirrhosis. There was a significant correlation between serum leptin levels and BMI when all the subjects were evaluated together(r=0.38,P=0.015)but none in the cirrhosis group when evaluated alone (r= 0.34,P=0.11). Serum leptin levels in cirrhosis correlated significantly with TSF (r=0.61,P=0.027),no significant correlation was observed in patients between leptin and TP or ALB,or PA. Conclusion The serum leptin levels are marked higher in patients with cirrhosis. Serum Leptin correlates strongly with TSF,suggesting that serum leptin level can reflect nutritional status of the patients.

关 键 词：血清瘦素 肝硬化患者 前白蛋白 营养状态 总蛋白 BMI 相关性 水平 皮褶厚度 身高 

分 类 号：R575.2[医药卫生—消化系统] R692[医药卫生—内科学]