血清内脂素、Vaspin与糖尿病肾病的相关性

Relationship between serum levels of visfatin and vaspin and diabetic nephropathy

目的 探讨2型糖尿病肾病患者血清内脂素、丝氨酸蛋白酶抑制剂（vaspin）水平与糖尿病肾病的相关性.方法 选择98例2型糖尿病患者,根据尿白蛋白排泄率分为3组：正常蛋白尿组（UAER＜ 20 μg/min）35例,微量蛋白尿组（UAER 20～200 μg/min）33例,大量蛋白尿组（UAER＞ 200 μg/min）30例;另选健康体检正常者35例为对照组.采用酶联免疫吸附法（ELISA）检测受检者血清内脂素、vaspin水平,同时测定空腹血糖（FPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、空腹胰岛素（FIns）,并测量体质量指数（BMI）、收缩压（SBP）和舒张压（DBP）,比较各组间差异.结果 3组患者血清内脂素水平明显高于对照组,差异有统计学意义（P＜0.01）;血清vaspin在正常蛋白尿组明显高于对照组、微量蛋白尿组和大量蛋白尿组,差异有统计学意义（P＜0.01）.内脂素和vaspin分别与BMI、SBP、FPG、HbA1c、LDL-C和FIns呈正相关（P＜0.01）,与HDL-C呈负相关（P＜0.01）.结论 血清内脂素水平随着2型糖尿病肾病的发展而逐渐升高,可能参与了2型糖尿病肾病的发生、发展,而vaspin与肥胖、体脂分布以及脂代谢关系密切,可以作为早期2型糖尿病监测指标.

Objective To explore the relationship between serum visfatin and vaspin and diabetic nephropathy in type 2 diabetic patients with nephropathy. Methods S98 patients with type 2 diabetes mellitus were divided into three groups according to the urinary albumin excretion rate （UAER）： normal albuminuria group （UAER〈 20 μg/min, 35 cases）, micro-albuminuria group （UAER 20-200μg/min, 33 cases） and macro-albuminuria group （UAER〉200 μg/min, 30 cases）. 35 healthy subjects were included as control group. Serum level of visfatin and vaspin were measured by enzyme linked immunosorbent assay （ELISA）. Then, fasting plasma glucose （FPG）, HbA1 C, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein cholesterol （HDL-C）, low density lipoprotein cholesterol （LDL-C） and fasting insulin （Fins） levels together with UAER were determined as well. Results The serum levels of visfatin in the diabetic patients were significantly higher than those in control group （P〈 0.01）. Serum vaspin levels in the normal albuminuria group were higher than control group, micro-albuminuria group and macro-albuminuria group （P〈O. 01）. Serum Ievels of visfatin and vaspin were positively correlated with BMI, SBP, FPG, HbAlc, LDL-C and Fins （ P 〈 0.01 ）, while negatively correlated with HDL-L（P 〈 0.01 ）. Conelusion The level of visfatin may play a important role in the pathogenesis and development of DN.Serum vaspin 1 evel is related to obesity, body fat distribution, lipid metabolism, so vaspin can be used as indicators to monitor T2DM in early stage.