糖尿病肾病患者血清网膜素-1水平的变化

Changes of serum omentin-1 in patients with diabetic nephropathy

目的通过比较2型糖尿病肾病(DN)患者、新诊断的2型糖尿病(T2DM)患者、糖耐量正常者(NGT)血清网膜素-1的浓度,探讨网膜素-1与DN的关系,为糖尿病早期诊断、病情监测、DN的发病机制提供依据。方法纳入2013年6月至2014年10月山西医科大学第二医院内分泌科、肾内科住院的50例DN患者(Ⅲ期25例,Ⅳ期25例),内分泌科门诊新确诊的46例T2DM患者,以及年龄、性别等相匹配的44例NGT者。测定所有受试者的空腹血糖(FPG)、血脂、血肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(HbA1c)、尿微量白蛋白(MAU)、空腹血清胰岛素(FINs)、网膜素-1。结果 3组的性别、年龄、BMI值差异均无统计学意义。T2DM组、DN组的FBG、HbA1c、TG、HOMA-IR均显著高于NGT组(P<0.05),低密度脂蛋白(LDL)-C、网膜素-1水平均低于NGT组(P<0.05)。DN患者的Scr、BUN均显著高于新诊断的T2DM患者,而FBG、HbA1c、TG、FINs、网膜素-1水平则显著低于新诊断的T2DM患者(P<0.05)。结论血清网膜素-1水平随着糖尿病病程进展呈下降趋势。网膜素-1水平的下降使得其抑制炎症作用降低可能是DN的发病原因之一,网膜素-1是否能成为T2DM病情、DN肾功能监测指标之一,仍需进一步研究。

Objective To investigate the correlation between omentin-1 and type 2 diabetes mellitus （T2DM） nephropathy by comparing the concentration of serum omentin-1 in patients with diabetic nephropathy （DN） and newly diagnosed T2DM, and subjects with normal glucose tolerance （NGT）, and to provide evidence for the early diagnosis, disease monitoring and pathogenesis of DN. Methods Fifty DN patients （stage 111： n=25, stage IV： n=25） who were hospitalized in the Department of Endocrinology and the Department of Nephrology, Second Hospital of Shanxi Medi- cal University between June 2013 and October 2014, 46 T2DM patients who were newly diagnosed by the Department of Endocrinology, and 44 age and gender matched subjects with NGT were included in the study. The levels of fasting plasma glucose （FPG）, serum lipids, serum creatinine （Scr）, blood urea nitrogen （BUN）, hemoglobin Alc （HbMc）, mi- croalbminurine （MAU）, fasting insulin （FINs）, and omentin-1 in all subjects were determined. Results There were no significant differences in gender, age and BMI among the three groups. The levels of FBG, HbAIc, TG and HOMA-IR in the T2DM group and DN group were significantly higher than those in the NGT group （P〈O.05）, whereas the levels of LDL-C and omentin-1 were lower than those in the NGT group （P〈0.05）. The levels of Scr and BUN in the DN pa- tients were significantly higher than those in the newly diagnosed T2DM patients, whereas the levels of FBG, HbMc, TG, FINs, and omentin-1 were significantly lower than those in the newly diagnosed T2DM patients （P〈0.05）. Con- clusion The level of serum omentin-1 decreases with the progression of diabetes mellitus. The down-regulation of o- mentin-1 decreases its inhibition of inflammation, which may be one of the causes of DN. Whether omentum-1 can be one of the monitoring indicators of T2DM condition and renal function in DN patients needs further study.