生长激素与糖尿病肾病关系的探讨

The relationship between Growth Hormone and Diabetic nephropathy

目的 探讨血清生长激素 (GH )与糖尿病肾病的关系。方法 6 7例 2型糖尿病(DM )患者根据尿白蛋白排泄率 (UAER)分为正常蛋白尿组 (NA)、微量蛋白尿组 (MA)和临床蛋白尿 (CDN )组 ,分别检测各组的血清GH、血糖 (PG)、HbA1c、胰岛素 (Ins)及TG、LDL、HDL、Lp(a)的水平 ,并与 18名正常人 (对照组 )进行比较。结果 CDN组的FGH明显高于对照组、NA组及MA组 (P <0 .0 1) ;MA组的空腹生长激素 (FGH)明显高于对照组和NA组 (P <0 .0 1) ;CDN组PGH明显高于NC组和对照组 (P <0 .0 1)。FGH与HbA1c、FPG、UAER、LDL、Lp(a)呈正相关 ;FGH与病程、FIns无相关。结论 GH水平的增高 ,加重糖代谢和脂代谢紊乱 ,参与糖尿病肾病的发生。

Objective To explore the relationship between serum GH and diabetic nephropathy(DN).Methods Sixty seven cases of type 2 diabetes mellitus patients were divided into three groups according to urine albumium excretion rate(UAER): normoalbuminuric(NA)group; microalbuminuric(MA) group; macroalbuminuric group(Clinical DN).Serum GH?PG?INS?HbA1c ?TG?LDL?HDL?Lp(a) were detected in all cases.Results Fasting growth hormone (FGH) in the CDN group is significantly higher than that in control(NC) group( P <0.01),NA group( P <0.01) and in MA group( P <0.01) ; FGH in MA group is significantly higher than that in NC group( P <0.01)and in NA group( P <0.01). PGH in MA group is significantly higher than that in NC group( P <0.01) and in NA group( P <0.01). FGH is positive correlated with HbA1c( r =0.546, P <0.01), FPG( r =0.437, P <0.01), UAER( r =0.486, P <0.01), LDL( r =0.379, P <0.05), Lp(a) ( r =0.430, P <0.01); but not correlated with fast plasma insulin( r = 0.029, P >0.05)and duration( r =0.22, P >0.05).Conclusion The elevation of GH is involved in the pathogenesis of diabetic nephropathy by exacerbation of disorders of sugur and lipid metabolism.