2型糖尿病患者血清胎球蛋白A水平与糖尿病肾病的相关性

Association between serum fetuin A and diabetic nephropathy in patients with type 2 diabetes

探讨2型糖尿病（T2DM）患者血清胎球蛋白A（Fetuin-A）水平与糖尿病肾病（DN）的相关性.选取T2DM患者正常蛋白尿（NA）组101例、微量白蛋白尿（MA）组87例、大量白蛋白尿（0A）组44例,另选取正常对照（NC）组130名.血清Fetuin-A在NC、NA、MA及OA组中水平依次升高,组间比较及组内两两比较差异均有统计学意义（P＜0.05或P＜0.01）;T2DM患者的Fetuin-A与病程、尿白蛋白/肌酐比值（ACR）、空腹血糖、餐后2h血糖及C反应蛋白（CRP）呈正相关（P＜0.05或P＜0.01）,与年龄及脂联素呈负相关（均P＜0.01）;多元逐步回归分析显示,病程、Fetuin-A、CRP及脂联素是ACR的独立影响因素（均P＜0.01）.Fetuin-A可能通过促炎性效应及抑制脂联素表达参与DN的发生发展.

The association between serum fetuin A and diabetic nephropathy （DN） in patients with type 2 diabetes mellitus（T2DM） was investigated.Serum levels of fetuin-A and adiponectin were measured by ELISA and the clinical data were collected in 101 T2DM patients with normal albuminuria （NA group）,87 patients with microalbuminuria （MA group）,44 patients with overt albuminuria （OA group）,and 130 normal control subjects （NC group）.Fetuin-A levels increased progressively from NC,NA,MA,to OA groups,and there were significant differences among groups（P〈0.05 or P〈0.01）.Fetuin-A level in patients was positively associated with duration of illness,urinary albumin to creatinine ratio （ACR）,fasting blood glucose,2-hour postprandial blood glucose,and C-reactive protein（CRP,P〈0.05 or P〈0.01）,but was negatively associated with age and adiponectin （all P〈 0.01）.Multiple stepwise regression analysis indicated that duration of diabetes,fetuin-A,CRP,and adiponectin were independent determinants for ACR （all P 〈 0.01）.Fetuin-A may be involved in the development and pathogenesis of DN by proinflammatory effects and repressing adiponectin production.