Betatrophin在老年2型糖尿病患者肾脏损害中的表达及影响因素

The Expression and the Influential Factors of Serum Betatrophin in Older Patients with Type 2 Diabetes Mellitus

目的 探讨血清 Betatrophin 在老年2 型糖尿病患者肾脏损害各个时期中的表达及其影响因素.方法 选择2015 年4 月~2017 年3 月在我院治疗的2 型糖尿病患者112 例为研究对象, 按照尿白蛋白/肌酐 ( UACR) 不同分为尿白蛋白正常组43 例、微量白蛋白尿组37 例、大量白蛋白尿组32 例.另外同期选择在我院行健康体检的健康老年受试者48 例作为对照组.检测各组受试者空腹血糖 ( FPG) 、餐后2h血糖 (2hPG) 、空腹胰岛素 ( FINS)、餐后2h胰岛素 (2hPINS)、糖化血红蛋白 ( HbA1c) 、尿白蛋白、血/尿肌酐、空腹血清 C 肽 ( FCP) 、高密度脂蛋白胆固醇 ( HDL - C) 、低密度脂蛋白胆固醇(LDL-C) 、甘油三酯 ( TG) 、 Betatrophin、脂联素, 并计算胰岛素抵抗指数 ( HOMA -IR) 、肾小球滤过率 ( eGFR) .血清中Betatrophin与其他指标之间关系运用 Pearson 相关系数分析, 并进行多元回归分析.结果 2 型糖尿病老年患者血清中Betatrophin 表达水平与FPG、 2hPG、 FINS、 2hPINS、 HbA1c、 TC、 TG、LDL-C、 UACR以及HOMA-IR 呈现明显的正相关关系 ( P <0.05);经多元回归分析, HbA1c、 FINS、TG以及UACR是影响2 型糖尿病老年患者血清中Betatrophin表达的独立相关因子 ( P <0.05) .在健康对照组、尿白蛋白正常组、微量白蛋白尿组以及大量白蛋白尿组中, 血清中Betatrophin及脂联素表达水平依次明显升高, 且组间两两比较, 差异有统计学意义 ( P <0.05) .结论 Betatrophin 可能参与了糖尿病肾病的发生与发展, 且能够反映出糖尿病肾损害的不同阶段, 有望成为糖尿病肾病监测的又一新指标.

Objective To investigate the expression of betatrophin in serum and its influential factors in patients with type 2 diabetes mellitus.Methods A total of 112 patients with type 2 diabetes from April 2015 to March 2017 were enrolled.The patients were divided into 3 groups according to urine albumin to creatinine ratio(UACR),group with normal urinary albumin level(43 ca-ses),group with microalbuminuria(37 cases)and group with massive albuminuria(32 cases).48 healthy older persons undergoing physical examination were assigned to the control group.Fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),fasting insulin(FINS),2h postprandial insulin(2hPINS),glycosylated hemoglobin(HbA1c),urine albumin,blood/urine creat-inine,fasting serum C peptide(FCP),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),triglyceride(TG),betatrophin and adiponectin were tested.The index of insulin resistance(HOMA IR)and the rate of glo-merular filtration(eGFR)were estimated.The relationship between betatrophin and other indicators in serum was analyzed by using Pearson correlation coefficient and multiple regression analysis.Results The level of serum betatrophin in older patients with type 2 diabetes mellitus was significantly positively correlated with FPG,2hPG,FINS,2hPINS,HbA1c,TC,TG,LDL-C,UACR and HOMA-IR(P<0.05).Multiple regression analysis showed that HbA1c,FINS,TG and UACR were four independent factors,which affect the expression of betatrophin(P<0.05).The levels of betatrophin and adiponectin in control group,group with normal urinary albumin level,group with microalbuminuria and group with massive albuminuria were significantly increased in turn,and there were significant differences between the two groups(P<0.05).Conclusion Betatrophin may be involved in the development of dia-betic nephropathy,and may reflect the stages of diabetic kidney damage.