血清白介素-18与2型糖尿病肾病的相关性研究

Relationship between serum interleukin-18 and type 2 diabetic nephropathy

目的探讨血清白介素-18（IL-18）与2型糖尿病肾病（DN）的相关性。方法根据尿白蛋白排泄率（UAER）将98例2型糖尿病患者（DM组）分为正常白蛋白尿组（NA组，34例）、微量白蛋白尿组（MA组，33例）和临床蛋白尿组（CP组，31例），并设正常对照组（NC组）25例，同时检测各组血清IL-18、超敏C反应蛋白（hs-CRP）、糖化血红蛋白（HbA1C）、尿白蛋白和血脂、血压等指标，并记录糖尿病病程和计算BMI。结果（1）DM组血清IL-18中位数水平较NC组显著增高（P〈0.01）；DM组血清IL-18水平与糖尿病病程、HbA1C、hs-CRP、UAER呈正相关（均P〈0.01），而NC组血清IL-18水平与HbA1C、hs-CRP、UAER无相关（均P〉0.05）；hs-CRP、糖尿病病程、HbA1C、收缩压、IL-18与UAER呈正相关（均P〈0.01）。（2）MA和CP组的血清IL-18水平均较NA组显著升高（均P〈0.01），而CP组水平则较MA组显著升高（P〈0.01）。结论血清IL-18水平在2型DM患者中显著升高，且与HhA1C水平相关；同时血清IL-18水平的变化可能与2型DN早期阶段的病情进展相关。

Objective To investigate the relationship between serum interleukin-18（IL-18） and type 2 diabetic nephropathy. Methods Ninety eight patients with type 2 diabetes mellitus and 25 healthy controls were recruited in this study. Diabetic patients were divided by urinary albumin excretion rate （UAER） into 3 groups： normoalbuminuria （NA） group, microalbuminuria （MA） group and clinical proteinuria （CP） group. Meanwhile hemoglobinAlc （HbAlc） and lipid profile were also measured. Duration of diabetes was recorded, arterial blood pressure was measured and body mass index （BMI） was calculated as kg/m^2. Results The median serum IL-18 levels in diabetic group were significantly higher than those in control group. The serum IL-18 levels were positively correlated with duration of diabetes, HbA1c, hs-CRP and UAER in diabetic group （P〈0.01）. The serum IL-18 levels were not correlated with HbA1c, hs-CRP, UAER in control group （P〉0.05）. Hs-CRP, duration of diabetes, HbA1c, SBP and IL-18 were positively correlated with UAER （P〈0.01）. The serum IL-18 levels in either MA or CP group was significantly higher than that of NA group （P〈0.01）. The serum IL-18 levels in CP group were significantly higher than those of MA group （P〈0.01）. Conclusion Serum IL-18 levels may be a strong predictor for the progression of early stage nephropathy in type 2 diabetic nephropathy.