糖尿病肾病患者血清脂联素、脂蛋白A和白介素6水平变化及意义

The changes and clinical significance of the serum levels of adiponectin,lipoprotein A,interleukin 6 in patients with diabetic nephropathy

目的探讨糖尿病肾病(DN)患者血清脂联素(APN)、脂蛋白A(LP-A)、白介素6(IL-6)水平变化及临床意义。方法选取2016年6月至2018年6月收治的DN患者110例,依据24 h尿蛋白排泄量(UAER)分为早期组(60例,30~300 mg/d)、临床期组(50例,>300 mg/d),同期选取糖尿病(DM)患者和体检健康人员各50例,所有人员均检测血清APN、LP-A、IL-6水平。结果DN患者血清APN水平明显低于DM患者、健康人员,血清LP-A、IL-6水平和24 h UAER明显高于DM患者、健康人员,差异有统计学意义(P<0.05),DM患者、健康人员血清APN、LP-A、IL-6水平和24 h UAER比较,差异无统计学意义(P>0.05);临床期组血清APN水平明显低于早期组,临床期组血清LP-A、IL-6水平明显高于早期组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,血清APN与24 h UAER呈负相关(r=-0.802,P<0.01),血清LP-A、IL-6水平与24 h UAER呈正相关(r=0.811,P<0.01;r=0.823,P<0.01)。结论DN患者血清APN、LP-A、IL-6水平与其发生发展有关,可作为评估患者肾损伤的重要指标,值得临床推广应用。

Objective To investigate the changes and clinical significance of serum levels of adiponectin(APN),lipoprotein A(LP-A),interleukin-6(IL-6)in patients with diabetic nephropathy(DN).Methods A total of 110 patients with DN who were treated in our hospital from June 2016 to June 2018 were enrolled in the study.According to the 24 hour urinary protein excretion(UAER),the patients were divided into early period group(n=60,30~300mg/d)and clinical period group(n=50,>300mg/d),at the same time,the other 50 patients with diabetes mellitus(DM)and 50 healthy volunteers were enrolled in the study.The serum levels of APN,LP-A and IL-6 were detected in all the subjects.Results The serum levels of APN in patients with DN were significantly lower than those in patients with DM and those in healthy subjects,and the serum levels of APN,LP-A,IL-6 and 24h UAER in patients with DN were significantly higher than those in patients with DM and those in healthy subjects(P<0.05).However there were no significantly differences in serum levels of APN,LP-A,IL-6 and 24h UAER between the patients with DM and healthy subjects(P>0.05).The serum levels of APN in clinical period group were significantly lower than those in early period group,however the serum levels of LP-A,IL-6 in clinical period group were significantly higher than those in early period group(P<0.05).The Pearson correlation analysis showed that serum levels of APN were negatively correlated with those of 24h UAER,however the serum levels of LP-A and IL-6 were positively correlated with those of 24h UAER(P<0.05).Conclusion The serum levels of APN,LP-A,IL-6 in patients with DN are related to the occurrence and development of the disease,which can be regarded as the important indexes for evaluating renal injury of patients with DN.