2型糖尿病兼或有肾脏病者颈总动脉内中膜厚度与血清淀粉样蛋白A水平的关系

Association between serum amyloid A and intima-media thickness of common carotid artery in type 2 dia- betic patients within or without kidney disease

目的探讨2型糖尿病肾脏病患者颈总动脉内中膜厚度（CCA-IMT）与血清淀粉样蛋白A（SAA）水平的相关关系。方法2型糖尿病患者107例，依据尿蛋白排泄率（UAER）结果分为单纯糖尿病组（SDM组）38例：UAER〈30mg／24h；糖尿病肾脏病组（DKD组）69例：UAER≥30mg／24h。DKD组依据肾小球滤过率（GFR）水平分为2组，DKD早中期组34例：GFR〉30ml／min；DKD中晚期组35例：GFR≤30ml／min。测定血清SAA及CCA-IMT水平，进行多因素分析。结果DKD组SAA水平、CCA-IMT较SDM组高；DKD中晚期组SAA水平、CCA-IMT较SDM组、DKD早中期组升高。SAA水平与腰臀比、CAEA-IMT、三酰甘油呈正相关；年龄、SAA及UAER是影响CCA-IMT的相关因素。结论2型糖尿病肾脏病患者血清SAA明显升高，并与CCA-IMT密切相关。

Objective To explore the association between serum amyloid A （SAA） and intimamedia thickness of common carotid artery （CCA-IMT） in type 2 diabetic patients with nephropathy. Methods In 107 patients with type 2 diabetes （38 simple diabetic mellitus; 34 early diabetic nephropathy 35 later diabetic nephropathy） SAA level and CCA-IMT were determined. Results The SAA level and CCA-IMT in diabetic nephropathy group were significantly increased as compared with those in simple diabetic mellitus group. The patients in later diabetic nephropathy showed higher SAA level than in simple diabetic mellitus group and early diabetic nephropathy group. SAA level was positively correlated with waist hip ratio, CCA-IMT and triglycercide. Age, SAA level and urinary albumin excretion rate were the relative factors influencing CCA-IMT. Conclusions SAA level was elevated in type 2 diabetic patients with nephropathy and closed related to CCA-IMT.