血清鸢尾素与2型糖尿病肾病的相关性研究

Study on the correlation between serum Irisin and type 2 diabetic nephropathy

目的探讨2型糖尿病(T2DM)患者血清鸢尾素(Irisin)与糖尿病肾病(DN)的相关性。方法选取新诊断的40例单纯T2DM患者(SDM组)、41例T2DM早期肾病患者(EDN组)、42例T2DM临床肾病患者(CDN组),同时选取40例体检健康者为对照组(NC组),采用酶联免疫吸附试验(ELISA)测定空腹血清Irisin水平。结果 (1)4组血清Irisin水平由高到低依次为:NC组(320.48±107.03)ng/mL、SDM组(291.53±101.01)ng/mL、EDN组(278.54±93.48)ng/mL、CDN组(209.12±88.53)ng/mL,差异有统计学意义(P<0.05);(2)血清Irisin水平与胰岛素抵抗指数(HOMA-IR),空腹胰岛素(FINS)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血肌酐(Scr)、尿素氮(BUN)、肿瘤坏死因子-α(TNF-α)水平及尿清蛋白/肌酐(UAlb/Cr)比值呈负相关(r值分别为-0.592、-0.610、-0.614、-0.638、-0.538、-0.552、-0.589、-0.561,P<0.05),与超氧化物歧化酶(SOD)、高密度脂蛋白(HDL)水平呈正相关(r值为0.578、0.556,P<0.05);(3)回归分析显示:HOMA-IR、UAlb/Cr是Irisin的独立影响因素。结论 DN患者血清Irisin水平降低,血清Irisin与DN的严重程度相关。

Objective To explore the association of serum Irisin with diabetic nephropathy（DN）in patients with type 2diabetes mellitus（T2DM）.Methods Totally 40 cases of patients with newly diagnosed T2DM（SDM group）,41 cases of patients with early diabetic nephropathy（EDN group）,and 42 cases of patients with clinical diabetic nephropathy（CDN group）were selected,another 40 healthy individuals with normal glucose tolerance were selected as the controls（NC group）.Serum Irisin was measured by using ELISA method.Results（1）The serum Irisin levels of four groups from high to low were：NC group（320.48±107.03）ng/mL,SDM group（291.53±101.01）ng/mL,EDN group（278.54±93.48）ng/mL,CDN group（209.12±88.53）ng/mL,and the difference was statistically significant（P〈0.05）.（2）The correlation analysis showed that Irisin level was negatively correlated with insulin resistance index（HOMA-IR）,fasting insulin（FINS）,FPG,HbA1 c,Scr,BUN,TNF-αand UAlb/Cr（r=-0.592,-0.610,-0.614,-0.638,-0.538,-0.552,-0.589,-0.561,P〈0.05）,and positively correlated with superoxide dismutase（SOD）and HDL（r=0.578,0.556,P〈0.05）.（3）The regression analysis showed that UAlb/Cr and HOMA-IR were the independent influencing factors of Irisin.Conclusion The level of serum Irisin in DN patients is decreased,and the level of Irisin may be correlated with the severity of DN.