血液透析患者血清瘦素水平与骨密度和骨代谢的关系研究

摘要

Objective To investigate the relationship between serum leptin levels and bone mineral density and bone metabolism in hemodialysis patients. Methods A total of 94 hemodialysis patients were enrolled. The bone mineral density of femoral neck and lumbar spine bone were calculated using dual energy X-ray absorptiometry. The levels of serum leptin and β-cross laps (β-CTX) were detected by enzyme-linked immunoadsorbent assay (ELISA) and parathyroid hormone (PTH) was detected by radioimmunoassay. The bone-specific alkaline phosphatase (BAP) was detected by using automatic biochemical analyzer. Results The leptin levels were higher in female than that in male (t=2.44, P<0.05). The serum leptin level in female was negative related with PTH,β-CTX and BAP(r=-0.58,-0.23,-0.37, P<0.05). The serum leptin level in male was negative related with PTH and β-CTX (r=-0.41,-0.45, P<0.05). The serum leptin level in whole pa-tients was not related to BMD (r=0.06, 0.06,P>0.05). Conclusions The serum leptin levels of female hemodialysis pa-tients were significantly higher than that of the male. Serum leptin in female patients was relate with bone resorption and bone formation, and serum leptin in male patients was related with bone resorption while not related with bone formation. Serum leptin of whole patients was not related with BMD.%目的观察血液透析患者体内血清瘦素水平与骨密度、骨代谢指标之间的关系。方法94名血液透析患者均采用双能X射线骨密度仪检测计算股骨颈和腰椎骨的骨密度。采用酶联免疫法测定血清瘦素，放射免疫检定法测定甲状旁腺素（PTH），酶联免疫吸附法测定Ⅰ型胶原羧基端肽β特殊序列（β-CTX），采用全自动生化分析仪检测骨特异性碱性磷酸酶（BAP）。结果女性患者的血清瘦素明显高于男性患者（t=2.44，P＜0.05），且女性患者血清瘦素和PTH、β-CTX、BAP均呈负相关（r分别=-0.58、-0.23、-0.37，P均＜0.05），男性患者血清瘦素和PTH、β-CTX呈负相关（r分别=-0.41、-0.45，P均＜0.05）。所有患者的血清瘦素与骨密度相关性不明显（r分别=0.06、0.06，P均＞0.05）。结论血液透析患者女性的血清瘦素水平明显高于男性，女性患者血清瘦素与骨代谢呈负相关；男性患者中血清瘦素与骨代谢中的骨吸收负相关，而与骨形成无关。所有患者的血清瘦素与骨密度相关性均不明显。