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Gelsolin and Adipokines Are Associated With Protein-Energy Wasting in Hemodialysis Patients

机译：血液透析患者的凝溶胶蛋白和脂肪因子与蛋白质能量消耗有关

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摘要

Protein-energy wasting (PEW) contributes to mortality in hemodialysis (HD) patients. Adipokines regulate energy homeostasis and body weight. Circulating gelsolin can modulate inflammation and is correlated with HD mortality. Whether adipokines and gelsolin play important roles in PEW remains unclear. Based on the criteria proposed by the International Society of Renal Nutrition and Metabolism, we examined the associations between PEW and biomarkers (gelsolin, leptin, adiponectin, interleukin-6, tumor necrosis factor alpha [TNF-]) in 188 stable HD patients. Patients with PEW had significantly lower serum leptin levels, and tended to have higher adiponectin, TNF-, and lower gelsolin levels. Logistic regression analysis revealed that gelsolin, leptin, adiponectin, and blood urea nitrogen were independently associated with PEW score. Serum creatinine, TNF-, gender, renin-angiotensin system (RAS) blockade, and lipid-lowering agents were not associated with PEW score. Patients on lipid-lowering agents had lower PEW scores and those with RAS blockade had higher PEW scores. Our study confirms that gelsolin, adiponectin, and leptin are significant associates with PEW in HD patients. Further understanding of how these factors contribute to PEW may help design novel therapeutic strategies for PEW in chronic kidney disease.
机译：浪费蛋白质能量（PEW）会增加血液透析（HD）患者的死亡率。脂肪因子调节能量稳态和体重。循环凝溶胶蛋白可以调节炎症，并与HD死亡率相关。脂肪因子和凝溶胶蛋白是否在PEW中起重要作用尚不清楚。根据国际肾脏营养与代谢学会提出的标准，我们检查了188名稳定的HD患者中PEW与生物标志物（凝溶胶蛋白，瘦素，脂联素，白细胞介素6，肿瘤坏死因子α[TNF-]）之间的关联。 PEW患者的血清瘦素水平显着降低，并且脂联素，TNF-α和凝溶胶蛋白水平降低。 Logistic回归分析显示凝溶胶蛋白，瘦素，脂联素和血尿素氮与PEW评分独立相关。血清肌酐，TNF-α，性别，肾素-血管紧张素系统（RAS）阻滞剂和降脂药与PEW评分无关。使用降脂药的患者的PEW得分较低，而具有RAS阻滞剂的患者的PEW得分较高。我们的研究证实凝溶胶蛋白，脂联素和瘦素与HD患者的PEW显着相关。对这些因素如何导致PEW的进一步理解可能有助于设计针对慢性肾脏疾病的PEW的新颖治疗策略。

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