血清分泌型卷曲相关蛋白5水平与2型糖尿病肾病的相关性

Relationship study between serum secreted frizzled-related protein 5 level and diabetic nephropathy

目的探讨2型糖尿病(T2DM)患者血清分泌型卷曲相关蛋白5(SFRP-5)水平与糖尿病肾病(DN)的相关性。方法选择T2DM住院患者137例,根据尿白蛋白排泄率(UAER)分为3组:正常白蛋白尿组(A组)47例;微量白蛋白尿组(B组)45例;大量白蛋白尿组(C组)45例。选择50例健康体检者作为对照组。ELISA法检测血清SFRP-5,同时测定空腹静脉血糖(FBG)、血脂、肝肾功能、UAER。比较各组间的指标差异。结果 4组SFRP-5比较差异均有统计学意义(P<0.05)。T2DM患者血清SFRP-5的水平低于对照组,B组、C组血清SFRP-5水平高于A组,C组血清SFRP-5水平高于B组(均P<0.05)。血清SFRP-5水平与舒张压(DBP)、总胆固醇(CHO)、甘油三酯(TG)、FBG、空腹血清胰岛素(Fins)、胰岛素抵抗指数(HOMA-IR)、尿素氮(BUN)、肌酐(CR)、UAER呈正相关,与高密度脂蛋白(HDL)、肾小球滤过率(GFR)、总胆红素呈负相关。多元线性回归分析显示,UAER、HOMA-IR、空腹血糖(FBG)、空腹血糖(FBG)、尿酸(UA)、收缩压(SBP)、TG是SFRP-5的独立影响因素。结论T2DM患者血清SFRP-5水平随着UAER的增加而升高,两者可能参与糖尿病肾病的发生,并可能成为糖尿病肾病发生及发展过程中的新的标记物。

Objective To investigate relationship between serum secreted frizzled-related protein 5（SFRP-5）and diabetic nephropathy.Methods A total of 137 patients with type 2diabetes mellitus were enrolled.According to urinary albumin excretion rate,all patients with type 2diabetes mellitus were divided into three groups：normal albuminuria group（group A,n =47）,microalbuminuria group（group B,n =45）and macroalbuminuria group（group C,n =45）.The control group included 50 healthy individuals.Serum SFRP-5was determinated with ELISA method.Fasting venous blood samples were collected for glucose and lipid.Twenty-four hour urine was also collected for UAER.Differences of indexes were compared between groups.Results The level of serum SFRP-5between groups was statistically significant（P〈0.05）;The level of serum SFRP-5in T2 DM group was significantly lower than that of the normal control group（P〈0.05）;The levels of serum SFRP-5in the microalbuminuria group and macroalbuminruia group were significantly higher than that of normal albuminuria group（P〈0.05）,and the level of serum SFRP-5in the macroalbuminuria group was significantly higher than that of the microalbuminuria group（P〈0.05）.Correlation analysis showed that the levels of SFRP-5were positively correlated with DBP,CHO,TG,FBG,Fins,HOMA-IR,BUN,CR and UAER,and negatively correlated with HDL,eGFR and total bilirubin.Multiple linear regression analysis showed that the levels of UAER,HOMA-IR,FBG,UA,SBP and TG were independent influencing factors for SFRP-5.Conclusion Serum SFRP-5gradually increases as the urinary albumin excretion rate becomes higher in patients with type 2diabetes mellitus,both may be involved in the occurrence and development of diabetic nephropathy（DN）,and may Serum SFRP-5become a new marker of diabetic nephropathy.