2型糖尿病患者血浆内皮素-1与清蛋白尿的关系

Association between plasma endothelin-1 and albuminuria in patients with type 2 diabetic mellitus

目的探讨2型糖尿病患者血浆内皮素-1（ET-1）与尿清蛋白排泄率（UAER）的关系。方法采用免疫比浊法检测300例2型糖尿病患者的尿微量清蛋白水平，并根据UAER将其分为正常蛋白尿纽（n=184）、微量清蛋白尿组（n=76）和临床清蛋白尿组（n=40）。分别采用放射免疫法检测各组的血浆ET-1和血清胰岛素水平，并计算胰岛素抵抗指数（HOMA—IR）结果从微量清蛋白尿组到；临床清蛋白尿组，血浆ET-1水平依次增高，差异有统计学意义，均P〈0．01（t=6．451，30．696，19．381）。2型糖尿病患者血浆ET-1水平与UAER（r=0．421，P〈0．01）呈正相亳，调整年龄、性别、血压及血脂的影响后，血浆ET-1水平仍与UAER呈正相关（r=0．202，P〈0．05）。结论2型糖尿病患者ET-1与UAER密切相关，一定程度上可反映糖尿病肾脏病变程度。

Objective To investigate the association between plasma endothelin - 1 （ET - 1 ） and urinary ablumin excretion rate （UAER） in patients with type 2 diabetic mellitus. Methods The immunoturbidimetric method was used for the measurement of urinary microalbumin levels of 300 cases of type 2 diabetic mellitus. All 300 cases were divided into the normoalbuminuric group, microalbuminuric group and macroalbuminuric group based each consisting of 184. 76 and 40 cases respectively based on UAER level The plasma ET - 1 and serum insulin were measured by radioimmunoassay in all three groups, and then the insulin resistance by homeostasis model assessment （ HOMA -IR ） was calculated. Results The plasma ET - 1 levels were signficantly increased from lhe normoalbuminuric, microalbuminuric to macroalbuminuric group, showing significant differences among three groups, all P 〈 0.01 （ t = 6. 451. 30. 696. and 19. 381 respectively）. The plasma ET-1 level of the type 2 diabetic patients was directly related to the level of UAER （ r =0.421. P 〈0.01 ）. even after controlling for age, gender, blood pressure and blood lipid profiles （ r = 0. 202, P 〈 0. 05 ）. Conclusions Plasma ET - 1 proves to be closely associated with UAER. reflecting the severity of the renal lesions to some degree in type 2 diabetes.