糖尿病肾病患者血清同型半胱氨酸、白细胞介素-6水平与肾脏功能及预后的关系

The relationship between serum homocysteine,interleukin-6 and renal function and prognosis in patients with diabetic nephropathy

目的探讨糖尿病肾病患者血清同型半胱氨酸(Hcy)、白细胞介素-6(IL-6)水平与肾脏功能及预后的关系。方法选取绵阳市第三人民医院2016年11月至2017年11月收治的112例糖尿病肾病患者作为研究对象,检测所有患者血清Hcy、IL-6水平,分析Hcy、IL-6水平与糖尿病肾病分期的关系;采用Logistic回归分析探讨糖尿病肾病患者发生终末期肾病的风险因素。结果Hcy高水平Ⅲ、Ⅳ期患者人数分别为16、20例,明显高于对应低水平的患者,IL-6高水平Ⅲ、Ⅳ期患者人数分别为16、20例,明显高于对应低水平的患者;Hcy和IL-6水平与患者空腹血糖、胰岛素抵抗指数(HOMA-IR)、尿蛋白、肌酐、尿素氮、糖尿病肾病分期均有明显相关性(P<0.05)。Hcy、尿微量清蛋白、IL-6、HOMA-IR是发生肾功能不全的独立危险因素。结论血清Hcy、IL-6水平与患者肾脏功能及预后密切相关。

Objective To investigate the relationship between the serum level of homocysteine(Hcy) and interleukin-6(IL-6) in patients with diabetes and the renal function and prognosis of the patients. Methods A total of 112 cases of diabetic nephropathy admitted in the Third People′s Hospital of Mianyang from November 2016 to November 2017 were selected as the research object.The serum levels of Hcy and IL 6 were measured in all patients,and the relationship between the levels of Hcy and IL 6 and the stages of diabetic nephropathy was analyzed;Logistic regression analysis was used to investigate the risk factors of end-stage renal disease in patients with diabetic nephropathy. Results The number of stage Ⅲ and Ⅳpatients with high level of Hcy was 16 and 20 respectively,which was significantly higher than that of corresponding low level patients.The number of stage Ⅲ and Ⅳ patients with high level of IL-6 was 16 and 20 respectively,which was higher than that of corresponding low level patients.The levels of Hcy and IL-6 were positively correlated with fasting blood glucose,insulin resistance index (HOMA-IR),urinary protein,creatinine,urea nitrogen and stage of diabetic nephropathy( P <0.05).Hcy,urinary microalbumin,IL-6 and HOMA-IR were independent risk factors for renal insufficiency. Conclusion Serum levels of Hcy and IL-6 are closely related to renal function and prognosis.