同型半胱氨酸、白介素18、高敏C反应蛋白与2型糖尿病肾病的相关性研究

Clinical significance of serum levels of Hcy,interleukin-18 and high-sensitivity C reaction protein in type 2 diabetic patients with nephropathy

目的探讨血清同型半胱氨酸(Homocysteine,Hcy)、白介素18(Interleukin-18,IL-18)和高敏C反应蛋白(high-sensitivity C reaction protein,hsCRP)在2型糖尿病(type 2 Diabetic mellitus,T2DM)肾病发生、发展机制中的作用及临床意义。方法选择97例T2DM患者,根据尿白蛋白排泄率(urinary albumin excretion rate,UAER)分为正常蛋白尿组(UAER<20μg/min)35例、微量蛋白尿组(UAER 20～200μg/min)30例和大量蛋白尿组(UAER>200μg/min)32例,采用酶联免疫吸附法(ELISA)检测Hcy、IL-18水平,免疫比浊法测定hsCRP,同时测定尿素氮(BUN)、血肌酐(SCr)、UAER,与同期35例健康体检正常者(对照组)进行比较。结果 3组患者血清Hcy、IL-18和hsCRP水平明显高于对照组(P<0.01);Hcy、hsCRP、IL-18与BUN、Scr、UAER均呈正相关(P<0.01),而Hcy、IL-18分别与hsCRP呈正相关(P<0.01)。结论血清Hcy、IL-18和hsCRP可能参与了T2DM肾病的发生、发展,联合检测三者水平可能对评估早期糖尿病肾病有意义。

Objective To explore the roles of serum Hey, interleukin-18 （IL-18） and High-sensitivity C reaction protein （hsCRP） in the pathogenesis and progress of nephropathy among type 2 diabetic patients. Methods A total of 97 patients with type 2 diabetes mellitus （T2DM） were divided into three groups according to the urinary albumin excretion rate （UAER） ：normal albuminuria group （ UAER〈20 I^g/min,n = 35 ）, miero-albuminuria group （ UAER20 N 200 Ixg/min, n = 30 ） and macro-albuminuria （ UAER〉 200/~g/min, n = 32）. Thirty-five healthy subjects were used as controls. Serum levels of Hcy and interleukin-18 were measured by en- zyme linked immunosorbent assay （ELISA） and hsCRP levels were measured by immuno-turbidimetry. Blood urea nitrogen （BUN）, and serum creatinine （SCr） levels together with UAER were also determined. Results Serum levels of Hcy,IL-18 and hsCRP in the diabetic patients were significantly higher than those in the controls （P〈 0.01）Serum levels of Hey, IL-18 and hsCRP were positively correlated with BUN, SCr and UAER （P 〈 0. 01 ）. Serum levels of Hey and IL-18 were also positively correlated with hsCRP（ P 〈 0.01 ）. Conclusions Serum Hcy, IL-18 and hsCRP may play important roles in the pathogenesis and development of DM. Combina- tion of detection of these factors might be useful in evaluation of early DM.