血尿酸、肿瘤坏死因子-α水平与2型糖尿病肾病分期的相关性研究

Study on the correlation between serum uric acid, tumor necrosis factor-α levels and stage of type 2 diabetic nephropathy

目的探讨血尿酸(SUA)、肿瘤坏死因子-α(TNF-α)在2型糖尿病肾病不同分期患者中的表达水平和临床意义。方法选取我院收治的2型糖尿病患者130例,按照患者尿白蛋白排泄量和(或)24h尿蛋白定量将入选病例分为正常尿蛋白组(46例)、微量蛋白尿组(44例)及大量蛋白尿组(40例),另选取40例健康体检者为健康对照组。收集各组一般临床资料和相关生化指标,检测SUA、TNF-α水平,分析SUA、TNF-α与糖尿病肾病的相关性。结果正常尿蛋白组、微量蛋白尿组、大量蛋白尿组的SUA、TNF-α水平均高于健康对照组,且微量蛋白组、大量蛋白尿组SUA、TNF-α水平高于正常尿蛋白组,大量蛋白尿组SUA、TNF-α水平显著高于微量蛋白尿组(P<0.05)。多元回归分析显示,FPG、TG、Scr、SUA和TNF-α分别与UAER具有独立相关性,且SUA与TNF-α呈正相关(P<0.05)。结论SUA、TNF-α具有早期诊断糖尿病肾病和评估病情程度的临床价值。

Objective To investigate the expression levels and clinical significance of serum uric acid (SUA) and tumor necrosis factor-α(TNF-α) in patients with different stages of type 2 diabetic nephropathy. Methods A total of 130 patients with type 2 diabetes mellitus admitted in our hospital were divided into normal urinary protein group (46 cases), micro-albuminuria group (44 cases) and macro-albuminuria group (40 cases) according to the amount of urinary albumin excretion and/or 24-hour urinary protein quantification. Another 40 healthy people were selected as healthy control group. General clinical data and related biochemical indicators were collected and the levels of SUA and TNF-α were detected to analyze the correlation between SUA, TNF-α and diabetic nephropathy. Results The levels of SUA and TNF-α in the normal urinary protein group, micro-albuminuria group and macro-albuminuria group were higher than those in the healthy control group, and the levels of SUA and TNF-α in the micro-albuminuria group and macro-albuminuria group were higher than those in the normal urinary protein group. The levels of SUA and TNF-α in the macro-albuminuria group were significantly higher than those in the micro-albuminuria group (P<0.05). Multivariate regression analysis showed that FPG, TG, Scr, SUA and TNF-α were independently correlated with UAER, and SUA was positively correlated with TNF-α(P<0.05). Conclusion SUA and TNF-α have clinical value in the early diagnosis and assessment of diabetic nephropathy.