2型糖尿病患者血清APPL1与尿白蛋白排泄率的相关性研究

The correlation between level of serum APPL1 and urinary albumin excretion rate in patients with type 2 diabetes mellitus

目的研究2型糖尿病患者血清磷酸酪氨酸衔接蛋白1（APPL1）水平变化与尿白蛋白排泄率的关系，探讨APPL1在糖尿病肾病（DKD）发生发展中的意义。方法将288例初治2型糖尿病患者，根据尿白蛋白/肌酐比率（UACR）分为正常白蛋白尿组（UACR〈30 mg/g, n=116）、微量白蛋白尿组（UACR 30-300 mg/g, n=95）、大量白蛋白尿组（UACR〉300 mg/g, n=77），选取性别及年龄匹配健康体检者130名作为对照组，采用ELISA法测定血清APPL1、肿瘤坏死因子α（TNF-α）及脂联素水平。结果2型糖尿病患者血清APPL1含量较对照组显著升高（P〈0.01），且随UACR的升高而升高。2型糖尿病患者血清APPL1与估算的肾小球滤过率呈显著负相关（r=－0.246, P〈0.01），与HbA1C、低密度脂蛋白胆固醇、总胆固醇、三酰甘油、胰岛素抵抗指数、血肌酐、血尿素氮、收缩压、TNF-α、脂联素呈显著正相关（r=0.119、0.167、0.209、0.194、0.273、0.242、0.131、0.144、0.365、0.952, P〈0.05或P〈0.01）。结论2型糖尿病患者血清APPL1水平显著升高，且随着UACR的升高而升高，提示其可能参与DKD的发生发展。

Objective To investigate the association of adaptor protein, phosphotyrosine interacting with PH domain and leucine zipper 1（APPL1）with urinary albumin excretion rate in patients with type 2 diabetes mellitus（T2DM）, and to explore the role of APPL1 in the development of diabetic kidney disease（DKD）.Methods According to the urinary albumin/creatinine ratio（UACR）, 288 newly-diagnozed patients with T2DM were divided into normal albuminuria group（UACR〈30 mg/g, n=116）, microalbuminuria group（UACR 30-300 mg/g, n=95）, and macroalbuminuria group（UACR〉300 mg/g, n=77）. 130 healthy subjects with matched sex and age were used as control group. Serum APPL1, tumor necrosis factor α（TNF-α）, and adiponectin levels were measured by ELISA method.Results Serum APPL1 level in T2DM patients was significantly higher than that in control subjects（P〈0.01）, and increased with the rising of UACR. In patients with T2DM, serum APPL1 level was negatively correlated with estimated glomerular filtration rate（r=-0.246, P〈0.01）while it was positively correlated with HbA1C, low density lipoprotein cholesterol, total cholesterol, triglycerides, insulin resistance index, serum creatinine, blood urea nitrogen, systolic blood pressure, TNF-α, and adiponectin（r=0.119, 0.167, 0.209, 0.194, 0.273, 0.242, 0.131, 0.144, 0.365, and 0.952, respectively, P〈0.05 or P〈0.01）.Conclusion Serum APPL1 level in patients with T2DM was increased with the rising of UACR, suggesting that APPL1 may be involved in the development of DKD.