The Change Of Serum Levels Of The Zinc-alpha2-glycoprotein In Chronic Renal Failure And Its Relationship With Malnutrition

Objective: The incidence of lipid metabolism disorders and protein-energy- malnutrition among chronic renal failure patients is evidently higher than that among normal people. Zinc-α2-glycoprotein(ZAG) is a newly-found multifunctional adipokine specially excreted by fat cells, which has the feature of adjusting fat metabolism, therefore help to control the body weight. Recently, it's found that serum levels of the ZAG in chronic renal failure is on an evident rise, but relative reports on this aspect are very rare. In this study, we observed the change of ZAG level in serum of patients with chronic renal failure, in order to find out the relationship between the level change of zinc-α2–glycoprotein on chronic renal failure patients and protein-energy-malnutrition.Methods: 33 patients of chronic renal failure (CRF) were selected from the inpatients in the second hospital affiliated to DaLian Medical University from Oct. to Dec. 2010, among which 16 patients are male and 17 patients are female, with an average age of 61.3±11.1 years old . Of all the 33 patients, there are 25 dialysis patients ( 17 hemodialysis and 8 peritoneal dialysis) with the average dialysis time of 19.1±18.8 months, and 8 healthy people are from outpatient clinic (4 males and 5 females) with an average age of 53.1±11.4 years old.The primary diseases are nephritis (6 cases), Diabetic nephropathy (13 cases), hepertension associated nephropathy (10 cases), and 4 other cases.The patients were divided as:①according to the renal function: the normal renal function group and the abnormal renal function group②according to dialysis or not in CRF group: dialysis group or non-dialysis group③according to the albumin level in serum: malnutrition group (<35g/L )and normal nutrition group (>35g/L)④according to different dialysis methods: hemodialysis group and peritoneal dialysis group⑤according to diabetic in CRF group: diabetic group and non-diabetic group. Dialysis patients'vein blood sample (5 ml) was taken before dialysis, while non-dialysis patients and normal people's vein blood sample (5 ml) were taken after they got up in the morning. Samples were centrifugated for 5 minutes in normal temperature and were cryopreserved in -20℃.Serum concentrations of Zinc-α2-glycoprotein was checked by enzyme-linked Immunosorbent assay and BUN, Scr, Hb, Alb, ChoL, Trig were checked. Besides the correlation between ZAG and MAC,TSF, BMI, MAMC is also analysed.Results :1.Compared with normal renal function group, ZAG level of CRF group was significantly higher than that of normal renal function (P<0.001). ZAG level of CRF group was no correlation with BUN, Scr, ChoL,Trig, BMI,MAMC, It was negatively correlation with ALb, TSF (P<0.05).2. Compared with non-dialysis, there is no rise of ZAG level on dialysis group . ZAG level of dialysis group was no correlation with BUN, Scr, ChoL, Trig, Alb, Hb, BMI, TSF, MAMC .3.The ZAG level of malnutrition group (Alb<35g/L) in CRF group was higher than that of normal nutrition group (Alb>35g/L). (P<0.01).4. In dialysis group, the level of ZAG is no evident difference between hemodialysis and peritoneal dialysis .5.In CRF group, the level of ZAG in diabetic patients was higher than non-diabetic group. (P<0.05).Conclusion:1.The ZAG levels in CRF group is significantly higher than that of normal renal function group, especially higher in diabetic group. The ZAG level has something to do with malnutrition in CRF.2.There is no difference of the ZAG levels between hemodialysis and peritoneal dialysis.