糖尿病肾脏疾病患者高密度脂蛋白抗炎功能与肾功能的相关性研究

Anti-inflammatory function of high density lipoprotein and its relationship with renal function in patients with diabetic kidney disease

目的探讨DKD患者高密度脂蛋白(HDL)抗炎功能与肾功能的相关性。方法选取2015年1～11月于上海交通大学医学院附属瑞金医院内分泌科和肾脏科住院的T2DM患者75例,根据24 hUAER分为正常白蛋白尿组21例、微量白蛋白尿组29例和大量白蛋白尿组25例,另选同期健康体检者(NC组)33名,比较各组临床资料。以超速离心法提取各组HDL,分离人外周血单个核细胞(PBMC),以HDL预处理PBMC,检测PBMC的TNF‐α分泌情况。结果 NC组FPG、HbA1c、TG、TC和Scr低于其余各组,HDL‐C水平高于其余各组。相比肾功能正常的T2DM患者,DKD患者HDL可促使PBMC分泌更多的TNF‐α。结论 T2DM患者HDL抗炎功能受损,表现出一定的促炎作用,其HDL抗炎功能受损程度与肾功能呈负相关。

Objective To investigate the anti inflammatory function of high density lipoprotein(HDL)and its relationship with renal function in patients with diabetic kidney disease(DKD).Methods75 cases of T2 DM patients admitted to the Department of Endocrinology and Nephrology of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College from January to November at 2015 were selected.Patients with DKD were divided into three groups according to the results of 24 h UAER:normal albuminuria group(n=21),microalbuminuria group(n=29)and macroalbuminuria group(n=25). And healthy persons were selected as control group(NC group,n=33). HDL was extracted by ultracentrifugation. The human peripheral blood mononuclear cells(PBMC)were isolated. PBMC was pretreated with HDL in each group and TNF α secretion were measured.ResultsThe levels of fasting blood glucose(FPG),HbA1 c,triglyceride(TG),total cholesterol(TC)and serum creatinine(Scr)were significantly lower,while HDLC was higher in NC group than in other groups. Compared with T2 DM patients with normal renal function,HDL in patients with T2 DM combined with DKD can promote the secretion of TNF α in PBMCs.ConclusionThe anti inflammatory function of HDL was impaired in T2 DM patients,and showed a certain degree of proinflammatory effect. The degree of impaired antiinflammatory function of HDL was negatively correlated with renal function in T2 DM patients.