C肽对2型糖尿病肾病的保护作用及其机制的研究

Protective effect and mechanism of C peptide on type 2 diabetic nephropathy

目的探讨c肽对2型糖尿病肾病的保护作用及其机制。方法将66例2型糖尿病患者分为单纯胰岛素组和磺脲类降糖药组，记录年龄、性别、体质量指数（BMI）、病程等一般项目并测定空腹血糖、血浆c肽浓度、糖化血红蛋白。用酶比色法测定红细胞膜ATP酶及血浆一氧化氮水平并进行比较，分析其与c肽等指标的相关性；分析c肽水平与2型糖尿病肾病分期的关系。结果①2型糖尿病单纯胰岛素组红细胞膜ATP酶活性和血浆一氧化氮水平较磺脲类降糖药组为低（P〈0．05）；②2型糖尿病患者红细胞膜ATP酶活性与血浆C肽水平和胰岛素水平呈正相关，红细胞膜ATP酶活性与病程和年龄呈负相关；⑧2型糖尿病肾病的分期随血浆c肽浓度降低而逐渐升高。结论c肽通过改善2型糖尿病肾病患者红细胞膜ATP酶活性减轻肾脏损害。

Objective To study the protective effect of C - peptide on diabetic nephropathy and its mechanism. Methods Sixty - six cases of type 2 diabetes were divided into two groups （ insulin therapy group and insulin secretagogue therapy group）. Age, sex, BMI, course of disease were recorded and fasting blood glucose, plasma C -peptide levels and glycated hemoglobin were detected. Erythrocyte membrane ATPase activity and the level of plasma nitric oxide were detected by enzyme eolorimetric method. The relationships between C - peptide levels and the stages of diabetic nephropathy in type 2 diabetes were analyzed. Results ①Erythrocyte membrane ATPase activity and plasma nitric oxide levels were lower in insulin therapy group than those in insulin secretagogue therapy group （P 〈 0.05）. ②In type 2 diabetes, erythrocyte membrane ATPase activity was positively correlated with plasma C -peptide and insulin levels, while erythrocyte membrane ATPase activity was negatively correlated with course of disease and age. ③The phases of diabetic nephropathy gradually increased accompany with the decrease of plasma C -peptide level. Conclusions C -peptide could reduce kidney damage in type 2 diabetic nephropathy by elevating erythrocyte membrane ATPase activity.