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지속성 외래 복막투석 환자에서 혈관내피세포 기능이상에 대한 영양상태 및 만성 염증의 영향

Other Titles
 The Effect of Nutritional Status and Inflammation on the Endothelial Dysfunction in Continuous Ambulatory Peritoneal Dialysis Patients 
 이정은  ;  장태익  ;  박정탁  ;  이승철  ;  최훈영  ;  강신욱  ;  최규헌  ;  이호영  ;  차봉수  ;  이현철  ;  한대석 
 Korean Journal of Nephrology (대한신장학회지), Vol.23(6) : 907-919, 2004 
Journal Title
 Korean Journal of Nephrology  (대한신장학회지) 
Issue Date
Background: Cardiovascular mortality is increased in ESRD patients and is not completely explained by common cardiovascular risk factors. Therefore, more attention is being focused on non-traditional risk factors such as endothelial dysfunction, malnutrition, chronic inflammation. This study was performed to investigate whether chronic inflammation and malnutrition plays an important role on the endothelial dysfunction in ESRD patients. Methods: Seventy-five patients undergoing CAPD for more than six months were enrolled in the study. To evaluate the extent of endothelial dysfunction, flow-mediated vasodilation (FMD) of brachial artery was measured using doppler ultrasonography. The degree of chronic inflammation was assessed by measuring inflammatory markers (IL-6, hsCRP) and SGA was used to assess the nutritional status. Results: According to SGA grade, the patients were divided into 2 groups (group 1:normal nutritional status, group 2:malnourished status). In group 2, IL-6 was significantly higher compared to group 1. FMD and albumin level were significantly lower in group 2 (11.37±4.93 vs. 8.41±4.23%, 3.7±0.4 vs. 3.4±0.3 g/dL, p<0.05). When the patients were divided into groups according to hsCRP level (group 1:≥3 mg/L, group 2:<3 mg/L), BMI and fasting glucose were significantly higher in group 1 compared to group 2 (25.9±3.5 vs. 23.9±2.8 kg/㎡, 105.8±22.3 vs. 93.3±11.4 mg/dL). HDL-cholesterol was significantly lower in group 1 (37.4±9.3 vs. 45.3±12.9 mg/dL). FMD was decreased in group 1 compared to group 2 (7.35±4.23 vs. 11.57±4.76%). Multiple regression analysis showed that average hsCRP concentration was an independent factors affecting brachial FMD. Conclusion: These findings suggest that endothelial dysfunction is associated with markers of inflammation and malnutrition, and chronic inflammation and malnutrition can be a predisposing factors for atherosclerosis in CAPD patients.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박정탁(Park, Jung Tak) ; 이승철(Lee, Seung Chul) ; 이정은(Lee, Jung Eun) ; 이현철(Lee, Hyun Chul) ; 장태익(Chang, Tae Ik) ; 차봉수(Cha, Bong Soo) ; 한대석(Han, Dae Suk)
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