老年血液透析病人衰弱与血清瘦素及25-羟维生素D的相关性研究  

Correlation of frailty with serum leptin and 25-hydroxyvitamin D in elderly hemodialysis patients

作　　者：朱蓓[1] 杭乐佳 高飞[1] 袁海川[1] 赵卫红[1] ZHU Bei;HANG Lejia;GAO Fei;YUAN Haichuan;ZHAO Weihong(Department of Geriatric Nephrology,Jiangsu Province Hospital,Nanjing 210029,China;Nanjing Medical University,Nanjing 211116,China)

机构地区：[1]江苏省人民医院老年肾科,江苏省南京市210029 [2]南京医科大学,江苏省南京市211116

出　　处：《实用老年医学》2024年第6期603-606,共4页Practical Geriatrics

基　　金：江苏省老年健康科研项目(LKM202201);南京医科大学大学生创新创业训练计划项目(2023年)。

摘　　要：目的探究老年血液透析病人血清瘦素及25-羟维生素D[25(OH)D]水平,并分析其与透析病人衰弱的相关性。方法选取2021年4月至2023年4月我院收治的150例老年血液透析病人,依据Fried表型评价病人的衰弱情况,分为非衰弱组(51例),衰弱前期组(74例)和衰弱组(25例)。比较3组一般资料、血清瘦素、25(OH)D及心功能。采用多因素Logistic回归分析老年血液透析病人衰弱的影响因素。结果3组年龄、糖尿病比例、透析龄、左室舒张末期内径,以及白蛋白、镁、IL-6、瘦素、25(OH)D水平比较,差异均有统计学意义(P<0.01)。多因素有序Logistic回归分析显示,年龄、透析龄、糖尿病、镁、IL-6、白蛋白、瘦素、25(OH)D、左室舒张末期内径是老年血液透析病人衰弱的独立影响因素(P<0.05)。结论针对白蛋白水平低、瘦素水平高、25(OH)D水平低的老年血液透析病人采取积极干预措施,有利于延缓衰弱的进展。Objective To investigate the levels of serum leptin and 25-hydroxyvitamin D[25(OH)D],and to analyze their correlation with frailty in the elderly hemodialysis patients.Methods A total of 150 elderly hemodialysis patients admitted to our hospital from April 2021 to April 2023 were enrolled in this study.The patients were divided into non-frailty group(51 cases),pre-frailty group(74 cases)and frailty group(25 cases)according to Fried phenotype.The general data,serum leptin,25(OH)D and cardiac function of the three groups were compared.Multivariate Logistic regression was used to analyze the influencing factors of frailty in the elderly hemodialysis patients.Results There were significant differences in age,proportion of diabetes mellitus,dialysis age,left ventricular end-diastolic diameter,albumin,magnesium,IL-6,leptin and 25(OH)D levels among the three groups(P<0.01).Multivariate Logistic regression analysis showed that age,dialysis age,diabetes,magnesium,IL-6,albumin,leptin,25(OH)D and left ventricular end-diastolic diameter were the independent factors of frailty in the elderly hemodialysis patients(P<0.05).Conclusions It is important to intervene the low level of albumin,high level of leptin and low level of 25(OH)D to delay the progression of frailty in the elderly hemodialysis patients.

关 键 词：瘦素 25-羟维生素D 血液透析 衰弱 心功能 

分 类 号：R692[医药卫生—泌尿科学]