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慢性肾脏病-矿物质和骨代谢异常与能量代谢
薛澄,戴兵,梅长林*
0
(第二军医大学长征医院肾内科,上海 200433
*通信作者)
摘要:
慢性肾脏病-矿物质和骨代谢异常(CKD-MBD)的危害近年来日益受到重视,除传统致病因素外,能量代谢因子瘦素、胰岛素、脂联素等也参与了CKD-MBD的发生与发展。高瘦素血症可以通过直接和间接途径影响骨重塑;CKD患者伴有糖尿病会损伤成骨细胞功能,易发生低甲状旁腺素(PTH)动力不良性骨病;CKD患者脂联素水平升高的意义也与生理状态不同,可作为骨病严重程度的标记物。CKD-MBD与能量代谢的相互影响仍需要更多的基础和临床研究阐明,针对其分子机制的干预可能会给CKD-MBD带来新的治疗手段。本文将就CKD-MBD与能量代谢的相互影响作一综述。
关键词:  肾疾病  肾性骨病  能量代谢  瘦素
DOI:
投稿时间:2012-12-21修订日期:2013-05-08
基金项目:上海市浦江人才计划(12PJ1403300),上海市科委重大基础研究项目(12DJ1400300).
Chronic kidney disease-mineral and bone disorder and energy metabolism
XUE Cheng,DAI Bing,MEI Chang-lin*
(Department of Nephrology, Changzheng Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.)
Abstract:
The damage of chronic kidney disease-mineral and bone disorder (CKD-MBD) has drawn increasing attention in recent years. In addition to traditional pathogenic factors, energy regulatory factors such as leptin, insulin, and adiponectin also participate in the development and progression of CKD-MBD. Hyperleptinaemia can directly or indirectly affect bone formation. CKD patients with diabetes have injured osteoblast function and are liable to have low dynamic osteopathy with low parathyroid hormone (PTH). Adiponectin is increased in CKD patients, which can be used as a marker for severity of osteopathy. More basic and clinical researches are needed to elucidate the mutual influence between CKD-MBD and energy metabolism. The interventions targeting molecular mechanisms may bring new treatments to CKD-MBD. This paper reviewed the mutual influence of CKD-MBD and energy metabolism.
Key words:  kidney diseases  renal osteopathy  energy metabolism  leptin