血清鸢尾素与老年糖尿病肾病的关系

Relationship between serum irisin and senile diabetic nephropathy

目的探讨血清鸢尾素水平与老年糖尿病肾病（DN）临床代谢参数的关系。 方法选取单纯2型糖尿病患者40例（SDM组），尿微量白蛋白（UAER）〈30 mg/24 h；T2DM早期肾病患者40例（EDN组）, UAER 30～300 mg/d；临床肾病患者40例（CDN组），UAER ≥300 mg/24 h。检测三组身高、体质量、体质量指数（BMI）、血压、空腹血糖、血脂、肝肾功能相关指标及血清鸢尾素水平，采用Spearman相关分析法及多元线性回归分析法分析血清鸢尾素与老年糖尿病肾病代谢参数相关性。结果相对于SDM组，EDN组及CDN组的血清鸢尾素水平降低（P〈0.01），鸢尾素水平与体质量（r＝－0.216，P〈0.05）、收缩压（r＝－0.194，P〈0.05）、尿素氮（r＝－0.208，P〈0.05）、血肌酐（r＝－0.327，P〈0.01）呈负相关，与糖化血红蛋白（HbA1c）（r＝0.222，P〈0.05）、表皮生长因子受体（eGFR，r＝0.357，P〈0.01）呈正相关。结论DN患者血清鸢尾素水平降低，其可能参与糖尿病肾病的能量代谢紊乱、氧化应激、细胞因子表达及血管内皮功能紊乱的发生。

ObjectiveTo investigate the relationship between the serum irisin level and the clinical metabolic parameters of senile diabetic nephropathy （DN）.MethodsForty patients with type 2 diabetes mellitus （group SDM）, urine microalbumin （UAER） 〈30 mg/d; 40 patients with early T2DM nephropathy （group EDN）, UAER 30~300 mg/d; 40 cases of kidney disease patients （CDN group）, UAER≥300 mg/d were selected. The height, body mass, BMI, blood pressure, fasting blood glucose, blood lipid, liver and kidney function related indexes and the level of irisin in serum were detected. Spearman correlation analysis and multiple linear regression analysis were used to analyze the relationship between serum iririn and metabolic parameters of diabetic nephropathy in the elderly. ResultsThe serum irisin levels in group EDN and group CDN were lower than that in group SDM （P〈0.01）. The correlation analysis showed that the irisin level was negatively correlated with weight （r=-0.216, P〈0.05）, systolic blood pressure （r=-0.194, P〈0.05）, blood urea nitrogen （r=-0.208, P〈0.05）, serum creatine （r=-0.327, P〈0.01）, and positively correlated with HbA1c（r=0.222, P〈0.05）, epidermal growth factor receptor （eGFR） （r=0.357, P〈0.01）.ConclusionsSerum irisin levels in patients with DN are reduced, which may be involved in energy metabolic disorders, oxidative stress, cytokine expression and endothelial dysfunction in diabetic nephropathy.