二甲双胍对2型糖尿病患者尿单核细胞趋化蛋白-1排泄的影响

The effect of Metformin on urinary MCP-1 excretion in patients with type 2 diabetes

目的观察二甲双胍(Met)对T2DM患者尿单核细胞趋化蛋-1(MCP-1)排泄的影响,探讨其肾脏保护作用。方法 121例T2DM患者(T2DM组)根据抗糖尿病治疗方案分为胰岛素治疗(Ins)组和磺脲类治疗(SUs)组,上述两组再根据是否联合服用Met分别分为Ins治疗亚组和Ins联合Met治疗亚组,以及SUs治疗亚组和SUs联合Met治疗亚组,另选择24名健康对照(NC)组,比较各组FPG、2hPG、HbA1c、UAlb/Cr和尿MCP-1/Cr(UMCR)等指标。结果与NC组比较,T2DM组FPG[(4.85±0.10)vs(7.21±0.14)mmol/L]、2hPG[(5.24±0.22)vs(9.71±0.31)mmol/L]、HbA1c[(5.22±0.06)%vs(7.03±0.10)%]、UAlb/Cr[(13.63±1.03)vs(27.68±3.99)mg/g]和UMCR[(30.71±1.83)vs(95.96±17.10)pg/ng]升高(P<0.05);与Ins治疗亚组比较,Ins联合Met治疗亚组UAlb/Cr[(42.96±6.24)vs(10.48±1.98)mg/g]和UMCR[(116.2±10.47)vs(27.42±4.45)pg/ng]降低(P<0.05);与SUs治疗亚组比较,SUs联合Met治疗亚组UAlb/Cr[(52.43±7.80)vs(18.31±5.70)mg/g]和UMCR[(240.8±12.77)vs(53.58±8.11)pg/ng]降低(P<0.05)。相关分析显示,T2DM患者UAlb/Cr是UMCR的独立相关因素(P<0.001)。结论Met可减少T2DM患者尿MCP-1的排泄,该作用可能与其肾脏保护有关。

Objective To investigate the effect of Metformin on urinary MCP-1excretion in patients with T2 DM and explore its possible reno-protective mechanisms. Methods A total of 121 T2 DM patients were enrolled in this study and divided into two groups：insulin（Ins）treatment group and sulfonylurea（SUs）treatment group.Then the two groups were further divided into four subgroups according to combination of Metformin：Ins,Ins-Met,SUs and SUs-Met subgroup.Healthy subjects were selected as the normal control group（NC group,n=24）.FPG,2 hPG,HbA1 c,urinary albumin to creatinine（UAlb/Cr）and urinary MCP-1to creatinine（UMCR）were measured in all subjects.Results FPG [（4.85±0.10）vs（7.21±0.14）mmol/L],2hPG [（5.24±0.22）vs（9.71±0.31）mmol/L],HbA1c[（5.22±0.06）vs（7.03±0.10）%],UAlb/Cr [（13.63±1.03）vs（27.68±3.99）mg/g]and UMCR [（30.71±1.83）vs（95.96±17.10）pg/ng]were all increased in T2 DM patients than in NC group（P〈0.05）.UAlb/Cr（10.48±1.98）vs（42.96±6.24）mg/g and UMCR（27.42±4.45）vs（116.2±10.47）pg/ng were significantly decreased in Ins-Met group than in Ins group（P〈0.05）.UAlb/Cr（18.31±5.70）,（52.43±7.80）mg/g and UMCR（53.58±8.11）,（240.8±12.77）pg/ng were significantly decreased in SUs-Met group than in SUs group.UMCR was positively associated with UAlb/Cr in T2 DM patients（P〈0.001）. Conclusion Metformin can reduce the excretion of urinary MCP-1inpatients with T2 DM.This may be associated with its reno-protective effect.