外周血载脂蛋白E与2型糖尿病肾病的关系

Study on the Relationship between Peripheral Blood Apolipoprotein E Levels and Type 2 Diabetic Nephropathy

目的探讨外周血载脂蛋白E水平和2型糖尿病肾病的关系。方法回顾性分析2011年1月至2013年12月乐山市市中区人民医院收治的2型糖尿病患者的312例临床资料,通过自制的调查问卷收集患者的性别、年龄、糖尿病病程、体质指数、血压、既往病史以及实验室检查结果等临床资料。对比无糖尿病肾病组(161例)和糖尿病肾病组(151例)的各项临床资料,同时对比两组患者载脂蛋白E水平、尿白蛋白/肌酐比值和肾小球滤过率。结果糖尿病病程、合并高血压、糖尿病视网膜病变、尿白蛋白/肌酐比值、肾小球滤过率、载脂蛋白E为2型糖尿病合并肾病的独立危险因素。中、高载脂蛋白E水平组患者的尿白蛋白/肌酐比值(32.9±25.4和46.1±30.2)均显著高于低载脂蛋白E水平组患者(27.9±19.6)(均P<0.05),中、高载脂蛋白E水平组患者的肾小球滤过率(113.7±40.1和109.6±39.8)均显著低于低载脂蛋白E水平组患者(119.1±37.9)(P<0.05)。患者载脂蛋白E水平与尿白蛋白/肌酐比值呈正相关(r=0.559,P<0.05),载脂蛋白E水平与肾小球滤过率成负相关(r=-0.643,P<0.05)。结论载脂蛋白E水平与2型糖尿病肾病的发病有关,其水平的升高可促进糖尿病肾病病情的进展,临床应重视对载脂蛋白E水平的监测和干预。

0bjective To investigate the relationship between peripheral blood apolipoprotein E levels and diabetic nephropathy in type 2 diabetes. Methods The clinical data of 312 patients with type 2 diabetes were retrospectively analyzed through questionnaire to collect the patient＇s gender, age, duration of diabetes, body mass index, blood pressure, medical history and laboratory examination results. The clinical data of patients with nephropathy and without nepbropathy was compared, and the apolipoprotein E levels, urinary albumln/ereatinine ratio and glomerular filtration rate of the two groups were compared as well. Results The duration of diabetes, hypertension, diabetic retinopathy, urinary albumin/creatinine ratio, glomerular filtration rate,apolipoprotein E were independent risk factors of type 2 diabetes mellitus combined with nepbropathy （P 〈 0. 05 ）. The urinary aLbumin/creatinine ratio of the middle and high level apollpoprotein E group （32. 9 ±25.4 and 46. 1 ±30. 2） was sisnificantly higher than the low level apolipoproteln E group（27.9 ± 19.6） （ P 〈0. 05） ;the glomemlar filtration rate of the middle and high level apolipoprotein E group（ 113.7 ±40. 1 and 109. 6 ± 39.8 ） was lower than the low level apolipoprotein E group （ 119. 1 ± 37.9 ） （ P 〈 0. 05 ）. The level of patient＇s apolipoproteln E was positively correlated with the urinary albumln/creatinlne ratio （ r = 0. 559, P 〈 0. 05 ）, and the level of apolipoprotein E was negatively correlated with glomerular filtra- tion rate（ r = - 0. 643, P 〈 0. 05 ）. Conclusion The incidence of type 2 diabetic nephrelogy is associated with the level of apolipoprotein E, the elevated levels may promote the progression of diabetic nephropathy, and ellnleal attention should be naid to mtmltnrlnt, and interventinn on the levels of apolinonroteln E.