The Relationship Of Serum Interleukin-6、leptin And The TCM Syndromes In Non-Dialysis Patients With Chronic Kidney Disease

Object:From analysising the specific mechanisms of Interleukin-6 and Leptin and the relationship between them in the development of chronic kidney disease,exploring the the relationship of Interleukin-6、Leptin with malnutrition,cardiovascular disease and TCM syndromes in different periods(mainly CKD 3-5)of non-dialysis patients with chronic kidney disease.And searching for the objective standards and material bases of different syndromes of TCM concerning uremic toxins,thus providing bases for treating uremic toxins using traditional Chinese medicine.Methods:According to the diagnostic criteria of CKD,67 CKD patients were enrolled,which were divided into CKD Stage-3(36),CKD Stage-4(17),and CKD Stage-5(14).All patients were divided into different syndromes according to the syndrome differentiation standard of TCM and computed the scores of the syndrom.20 healthy subjects as controls were enrolled in the study.The blood samples were collected from all patinents for biochemical index detection.Echocardiography for experimental group was detected in the ultrasonography of our hospital.Serum concentrations of leptin and IL-6 were detected by enzyme-linked immunosorbent assay in the clinical laboratory of our hospital.Results:Serum concentrations of leptin、IL-6 in the experimental group were significantliy higher than that in the control group(P<0.05)and had negative correlation trend with GFR.Comparing with the control group,the serum concentrations of Hb,ALB and BMI in the experimental group were clearly lower(P<0.01).And the serum concentrations of leptin 、IL-6 had negative correlation trend with the serum concentrations of Hb,ALB and GFR in the experimental group.The relationships among the serum concentrations of leptin 、IL-6 and left ventricular mass index needed to be further confirmed because of the number of cases.Serum concentrations of IL-6 in the QI and YIN deficiency syndrome and the blood stasis syndrome were significantly higher than that in other different syndromes in CKD3(P<0.05).And in CKD4,the serum concentration of IL-6 in the syndrome of excess toxin was also higher than that in other different syndromes(P<0.05).Although the serum concentrations of IL-6 in Qi deficiency syndrome of spleen and kidney and Yang deficiency syndrome of spleen and kidney were also higher than that in other different syndromes in CKD4 group,and the serum concentrations of IL-6 in the Qi deficiency syndrome of spleen and kidney 、Yang deficiency syndrome of spleen and kidney and the blood stasis syndrome were also higher than that in other different syndromes in CKD5 group,there could not be analyzed because of the number of cases.The serum concentrations of Leptin in the YIN deficiency syndrome of liver and kidney and the blood stasis syndrome were significantly higher than that in other different syndromes in CKD3(P<0.05).Although the serum concentrations of Leptin in Dampness syndrome and the blood stasis syndrome were also higher than other syndromes in CKD4,the difference was not significant(P>0.05).The serum concentration of Leptin in Yang deficiency syndrome of spleen and kidney was also higher than that in other different syndromes in CKD4 and the serum concentrations of Leptin in YIN deficiency syndrome of liver and kidney、QI and YIN deficiency syndrome and the blood stasis syndrome were also higher than other syndromes in CKD5,but there could not be analyzed because of the number of cases.Conclusions:1.The serum concentrations of IL-6 and leptin in patients with chronic kidney disease(mainly CKD3-5)were significantly increased and have negative correlation trend with GFR.They might take part in the malnutrition in CKD patients,but the relationship among the serum concentrations of IL-6 and leptin with the left ventricular hypertrophy needed to be further confirmed because of the number of cases.2.Differentiated syndromes of TCM in CKD different stages might have certain correlation with the serum concentrations of IL-6 and leptin.The serum concentration of IL-6 was highest in QI and YIN deficiency syndrome among deficiency patterns and in the blood stasis syndrome among excess patterns in CKD3.The serum concentration of Leptin was highest in YIN deficiency syndrome of liver and kidney among deficiency patterns and in the blood stasis syndrome among excess patterns in CKD3 group.There could not be analyzed because of the number of cases in CKD4 and CKD5.