糖尿病肾病患者血清1,25-二羟基维生素D_3水平及其临床意义

Serum level of 1,25-dihydroxyvitamin D_3 and its clinical significance in patients with diabetic nephropathy

目的探讨糖尿病肾病(DN)患者的1,25-二羟基维生素D_3[1,25-(OH)_2D_3]的水平及其临床意义。方法根据尿白蛋白排泄率(UAER)水平,将200例2型糖尿病患者分为单纯糖尿病(DM)组56例、早期DN组55例、临床DN组45例、DN终末期组44例,并选取50例健康者作为对照组。采用酶联免疫吸附法测定受试者的1,25-(OH)_2D_3水平,并分析DN患者的1,25-(OH)_2D_3水平与UAER、肾小球滤过率的相关性。结果对照组、单纯DM组、早期DN组、临床DN组、DN终末期组的血清1,25-(OH)_2D_3水平依次降低(P<0.05)。DN患者的血清1,25-(OH)_2D_3与UAER呈负相关(P<0.05),与肾小球滤过率呈正相关(P<0.05)。结论DN患者的1,25-(OH)_2D_3水平均低于正常健康人群,其水平可能与DN的发生发展有关。

Objective To investigate the serum level of 1,25-dihydroxyvitamin D_3[1,25-（OH）_2D_3]and its clinical significance in patients with diabetic nephropathy（DN）.MethodsA total of 200 patients with type 2 diabetes mellitus were divided into simple diabetes mellitus（DM）group,early-stage DN group,clinical DN group and end-stage DN group according to urinary microalbumin excretion rate（UAER）,and 50 healthy subjects as control group.Enzyme-linked immunosorbent assay was used to determine the level of1,25-（OH）_2D_3in the subjects,and the correlation of the 1,25-（OH）_2D_3level with UAER and glomerular filtration rate was analyzed in the patients with DN.Results The levels of serum 1,25-（OH）_2D_3decreased in turn in the control group,simple DM group,early-stage DN group,clinical DN group and end-stage DN group（P0.05）.The level of serum 1,25-（OH）_2D_3negatively correlated with UAER（P0.05）,and positively correlated with glomerular filtration rate in the patients with DN（P0.05）.Conclusion Patients with DN have a lower level of 1,25-（OH）_2D_3compared to the normal healthy population,which might correlate with the pathogenesis and progression of DN.