糖尿病肾病患者血清chemerin和C反应蛋白水平的变化及其临床意义

Changes of Serum Chemerin and C-reactive Protein Level and Its Clinical Significance in Patients with Diabetic Nephropathy

目的探讨糖尿病肾病(DN)患者血清chemerin、C反应蛋白(CRP)水平的变化及其临床意义。方法选取2010年10月—2011年5月我院住院的2型糖尿病患者60例为研究对象,根据是否合并DN分为单纯糖尿病组30例和DN组30例,另选取同时期体检健康者30例为对照组。检测3组血压、血清空腹血糖(FPG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、尿素氮(BUN)、肌酐(Cr)、chemerin、CRP水平,并分析其相关性。结果 3组收缩压(SBP)、FPG、HbA1c、LDL-C、HDL-C、BUN、Cr、chemerin、CRP水平比较,差异均有统计学意义(P<0.01);其中单纯糖尿病组和DN组与对照组上述指标比较,差异均有统计学意义(P<0.05);DN组与单纯糖尿病组FPG、HbA1c、LDL-C、BUN、Cr、chemerin、CRP水平比较,差异均有统计学意义(P<0.05)。简单直线相关分析显示,chemerin与FPG、HbA1c、LDL-C、BUN、Cr均呈正相关(r值分别为0.513、0.294、0.151、0.523和0.652,P<0.05),与HDL-C呈负相关(r=-0.794,P<0.05);CRP与FPG、HbA1c、LDL-C、BUN、Cr均呈正相关(r值分别为0.497、0.285、0.341、0.517和0.646,P<0.05),与HDL-C呈负相关(r=-0.687,P<0.05);chemerin与CRP呈正相关(r=0.712,P<0.05)。结论血清chemerin、CRP水平与FPG、HbA1c、血脂、肾功能等有关,chemerin和CRP可能通过调节脂肪细胞生成和代谢平衡、胰岛素抵抗及炎症、内皮细胞损伤等机制参与DN的发生、发展。

Objective To investigate the changes of serum chemerin and CRP levels of Diabetic Nephropathy （DN） patients and to explore the possible correlations between chemerin, CRP and DN. Methods 60 in - patients with type 2 diabetes mellitus （T2DM） admitted to our hospital from October 2010 to May 2011 were divided into pure diabetes group （30 cases） and DN group （30 cases）. 30 healthy people who underwent physical examination in the same period were selected as control group. Blood pressure, fasting plasma glucose （ FPG）, glycosylated hemoglobin （ HbA1c ）, low - density lipoprotein cholesterol （ LDL - C）, high - density lipoprotein cholesterol （ HDL - C）, urea nitrogen （ BUN）, creatinine （ Cr）, chemerin and CRP were detected in the three groups and their correlations were analyzed. Results The levels of SBP, FPG, HbA1c, LDL - C, HDL -C, BUN, Cr, chemerin and CRP between the three groups all showed statistically significant differences （P 〈 0. 01 ）. The pure diabetes group and DN group showed statistically significant differences in the above indicators compared with the control group （P 〈 0. 05）. The pure diabetes group and DN group showed statistically significant differences in FPG, HbA1c, LDL - C, BUN, Cr, chemerin and CRP （P 〈0. 05 ）. Simple linear correlation analysis showed that chemerin was positively correlated withFPG, HbA1c, LDL-C, BUN and Cr （r=0.513, 0.294, 0.151, 0.523 andO. 652, P〈0.05）, but was negatively correlated with HDL - C （r = - 0. 794, P 〈 0. 05）. CRP was positively correlated with FPG, HbAIo, LDL - C, BUN and Cr （r =0. 497, 0. 285, 0. 341, 0. 517 and 0. 646, P 〈 0. 05） , but was negatively correlated with HDL - C （r = - 0. 687, P 〈 0. 05 ）. Chemerin was positively correlated with CRP （ r = 0. 712, P 〈 0. 05 ）. Conclusion Serum chemerin and CRP level are related to FPG, HbA1c, blood lipid and kidney function. The chemerin and CRP may be involved into the occurrence and devel- opment of DN through adjusting the adipose cell formation and metabolic balance, insulin resistance, inflammation and endotheli- al cell damage mechanisms.