摘要
目的检测2型糖尿病肾病(DN)患者血清nesfatin-1水平,探讨血清nesfatin-1水平与2型糖尿病肾病的关系。方法根据尿清蛋白/肌酐比值(ACR)将115例2型糖尿病患者分为正常清蛋白尿组(NA组,38例)、微量清蛋白尿组(MA组,39例)及临床清蛋白尿组(CP组,38例),选取同期健康体检人群作为对照组(NC组,40例)。采用酶联免疫吸附法(ELISA)测定血清nesfatin-1水平,同时测定患者空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(Hb A1c)、血脂、血肌酐(Scr)、尿素氮(BUN)、C反应蛋白(CRP),计算体重指数(BMI)、胰岛素抵抗指数(HOMA-IR),比较各组间的差异并进行相关分析。结果与NC组比较,3组糖尿病患者血清nesfatin-1水平均显著降低(P<0.05);与NA组、MA组比较,CP组的nesfatin-1最低(P<0.05),而NA组和MA组比较差异无统计学意义(P>0.05);相关分析显示血清nesfatin-1与收缩压、HOMA-IR、Scr、ACR、CRP呈负相关(r=-0.243、-0.486、-0.374、-0.228和-0.219,P<0.05);多元线性回归分析显示HOMAIR、Scr、ACR与血清nesfatin-1独立相关r=0.352、0.264和0.225);控制HOMA-IR影响,偏相关分析结果发现血清nesfatin-1与其他指标均无明显相关性(P>0.05)。结论 T2DM患者nesfatin-1水平降低,而且DN患者CP组nesfatin-1水平最低。DN患者血清nesfatin-1水平的下降可能与胰岛素抵抗的加重密切相关。
[Objective] To investigate the change of serum nesfatin-1 in type 2 diabetic patients with nephropathy. [Methods] A total of 115 patients with type 2 diabetes mellitus were divided into three groups according to the urinary albumin/creatinine ratio (ACR): normal albuminuria group (NA group) with 38 cases, micro-albuminuria group (MA group) with 39 cases and macro-albuminuria group (CP group) with 38 cases; and 40 healthy subjects were included as controls. Serum level of nesfatin-1 was assayed by enzyme linked immunosorbent assay (ELISA). Fasting plasma glucose (FPG), fasting plasma insulin (FINS), HbAlc, lipids, serum ereatinine (Scr), blood urea nitrogen (BUN) and C-reactive protein (CRP) levels together with ACR were also determined. [Results] Serum nesfatin-1 level in the diabetic patients was significantly lower than that in the controls (P〈 0.05); the lowest level was in the CP group which was significantly different from those in the groups NA and MA (P〈 0.05). The levels of nesfatin-1 were negatively correlated with systolic pressure, HOMA-IR, Scr, ACR and CRP (r=-0.243, -0.486, -0.374, -0.228 and -0.219, P〈 0.05). Multiple linear re- gression analysis showed that HOMA-IR, Scr and ACR were independent related factors to the serum nes- fatin-1 (r=0.352, 0.264 and 0.225), Control the effect of HOMA-IR, partial correlation analysis showed that serum nesfatin-1 and other parameters were not significantly correlated (P〉 0.05). [Conclusions] Serum nesfatin-1 level in diabetic patients is significantly lower than that in health controls, and it is the lowest in the patients with macro-albuminuria. The decrease of serum nesfatin-1 level could be associated with increased insulin resistance.
出处
《中国现代医学杂志》
CAS
北大核心
2015年第33期36-39,共4页
China Journal of Modern Medicine