NoX与2型糖尿病肾功能及尿清蛋白排泄率的相关性研究

The relationship between NOX,kidney function and urinary albumin excretion rate in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者尼克酰胺腺嘌呤二核苷酸磷酸氧化酶(NOX)的变化与肾功能及尿清蛋白排泄率(UAER)的关系,并分析比较氧化应激指标与糖尿病肾脏损害程度的相关性。方法将100例2型糖尿病患者,排除感染应激和急慢性代谢紊乱,其中,50例为无肾病糖尿病组,另50例患者为糖尿病性慢性肾脏疾病(DKD)组,健康对照组50例。测定2组患者空腹血糖、肾小球功能、血和尿肌酐水平,以及血中糖化血红蛋白(HbA1c)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、NOX、8-羟基脱氧鸟苷(8-OHdG)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。同时留取所有受试者3次不同时间清洁尿液检测尿清蛋白与尿肌酐比值,计算UAER。结果无肾病糖尿病组体内NOX、8-OHdG、MDA明显高于健康对照组,SOD明显低于健康对照组;而DKD患者NOX、8-OHdG UAER明显高于无肾病糖尿病组,Logistic回归分析显示NOX与DKD更为紧密(OR=1.199,P<0.01)。结论与3个氧化应激指标8-OHdG、MDA、SOD相比,NOX更能确切地反映2型糖尿病肾病患者体内的氧化应激水平,即NOX是反映氧化应激水平与2型糖尿病肾脏损害相关的更为理想的指标。

Objective To observe the relationship between the change of NOX and renal function and urinary albumin excre- tion rate（UAER） in type 2 diabetes patients, and demonstrates the relationship of oxidative stress indicators and diabetic kidney damage. Methods Totally 100 cases of patients with type 2 diabetes mellitus,eliminated infection stress and acute and chronic met- abolic disorder,of which 50 cases for non diabetic nephropathy group and the other 50 cases of patients for diabetic chronic kidney disease （DKD） group ~ healthy control group （50 cases）. The levels of FBG, renal function, Cr in blood and urine, HbAlc,TG,TC, LDL, NOX,8-OHdG, MDA, SOD were measured. While specimens from all subjects at three different time of clean urine urine albu- min / creatinine ratio were calculated for UAER, Results Compared with healthy control group,diabetes with non kidney disease group had higher NOX,8-OHdG,MDA,and had significantly lower ievel in the serum SOD level^but compared with diabetes with non kidney disease group, the DKD group had even higher in UAER, NOX, 8-OHdG, Logistic regression anaiysis revealed that NOX were positively associated with DKD（OR=1. 199,P〈0.01）. Conclusion Compared with serum 8-OHdG,MDA and SOD,the ser- um NOX level can more accurately reflect the level of oxidative stress in the body,and can be as an ideal index to reflecting the rela- tionship between oxidative stress and diabetes chronic kidney damage.