瘦素及可溶性瘦素受体在原发性肾病综合征患儿血脂升高中的作用  

Role of Serum Leptin and Soluble Leptin Receptor in Children with Primary Nephrotic Syndrome

作　　者：王建军[1] 杨锡强[1] 魏钰书[2] 赵耀[1] 罗晓菊[1] 李睿[3] 

机构地区：[1]重庆医科大学儿童医院免疫室,重庆400014 [2]川北医学院附属医院儿科,四川南充637000 [3]泰山医学院附属医院儿科,山东泰安271000

出　　处：《实用儿科临床杂志》2005年第11期1098-1100,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨瘦素(Leptin)及可溶性瘦素受体(sOBR)在儿童原发性肾病综合征(PNS)血脂升高中的作用。方法检测23例未经治疗的PNS患儿空腹血清血脂、血浆清蛋白、Leptin、sOBR、胰岛素及尿Leptin、sOBR水平,并与在年龄、性别、体质量指数(BMI)均匹配的15例正常儿童比较。结果肾病组血胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、载脂蛋白B(apoB)水平增高,血浆清蛋白、胰岛素水平较对照组降低。空腹血清总Leptin水平肾病组与对照组相当,而尿Leptin水平肾病组高于对照组;血清sOBR水平肾病组降低,尿sOBR水平二者无差异;血清游离Leptin指数(FLI)肾病组高于对照组。肾病组游离Leptin指数(FLI)与血浆清蛋白、HDL、apoA呈正相关,与LDL、胰岛素呈负相关。结论PNS患儿血清sOBR减少,游离瘦素增多可能为一抗高脂血症的代偿机制,但其纠正PNS脂代谢紊乱的能力并不完全。Objective To analyze the probably role of leptin and soluble leptin receptor （sOBR） on hyperlipidemia in children with primary nephrotic syndrome（PNS）.Methods Twenty-three children with untreated PNS and 15 healthy controls age, sex, and body mass index（BMI）matched were included in the study. Fasting blood lipids, albumin, leptin, sOBR, insulin levels and urine leptin, sOBR levels were measured in both groups. Results LDL, TC, TG and apoB levels were increased in the PNS group, and plasma albumin and insulin were decreased compared with that in the control group. HDL and apoA levels were similar in two groups. Serum sOBR level was significantly lower in the PNS group compared with the control subject, whereas fasting serum leptin level was not significantly different between, the two groups. Urinary sOBR excretion was similar in both groups, whereas urinary leptin in patient group was higher than that in control group. And the serum free leptin index （leptin/sOBR, FLI） was significantly higher in the PNS group. FLI showed positive correlation with plasma albumin, HDL, apoA and negative correlation with LDL and insulin in patient group. Conclusions The reduction of sOBR in serum of PNS enhancing the biologically active form of leptin may be a complemental mechanism against hyperlipidmia which is not capable of completely controlling the lipid metabolism disorder.

关 键 词：肾病综合征 高脂血症 瘦素 

分 类 号：R726.91[医药卫生—儿科]