2型糖尿病肾病患者血清25-羟维生素D和α1-微球蛋白水平的变化及临床意义

Changes and clinical significance of serum levels of 25-hydroxyvitamin D andα1-microglobulin in patients with type 2 diabetic nephropathy

目的探讨2型糖尿病(T2DM)患者中糖尿病肾病(DKD)的血清25-羟维生素D[25(OH)D]和α1-微球蛋白(α1-MG)水平变化,分析其在早期DKD诊断中的临床意义。方法将110例T2DM患者分为单纯糖尿病组(A组,43例)、微量白蛋白尿组(B组,34例)和大量蛋白尿组(C组,33例),检测与比较各组血清25(OH)D和α1-MG水平,分析其与尿微量白蛋白/肌酐比值(UACR)的相关性。结果与A组比较,B组和C组的25(OH)D水平降低(P<0.05),且C组低于B组(P<0.05)。与A组、B组比较,C组的α1-MG水平增高(P<0.05)。C组血清光抑素C(CysC)水平高于A组(P<0.05)。血清25(OH)D水平与UACR呈负相关(P<0.05),血清α1-MG及CysC水平与UACR呈正相关(P<0.05)。结论DKD患者血清25(OH)D水平降低,α1-MG水平升高;两者均与患者肾脏损害程度密切相关,可为其早期诊断提供理论依据。

Objective To investigate the changes of serum levels of 25-hydroxyvitamin D[25(OH)D]andα1-microglobulin(α1-MG)in the patients with type 2 diabetes mellitus(T2 DM)combined with diabetic nephropathy(DKD)and to analyze the clinical significance of serum 25(OH)D andα1-MG in the diagnosis of early DKD.Methods A total of 110 patients with T2 DM was divided into three groups of A(with simple T2 DM,43 cases),B(with microalbuminuria,34 cases)and C(with massive proteinuria,33 cases).Serum levels of 25(OH)D andα1-MG were measured and compared among the three groups.The correlation of 25(OH)D andα1-MG with the ratio of urine microalbumin to creatinine(UACR)was analyzed.Results Compared with group A,serum 25(OH)D level in groups of B and C was lower(P<0.05),which was lower in group C than that in group B(P<0.05).Serumα1-MG level of group C was higher than that of groups of A and B(P<0.05).Serum cystatin C(CysC)level in group C was higher than that in group A(P<0.05).Serum 25(OH)D level was negatively correlated with UACR(P<0.05).Serum levels ofα1-MG and CysC were positively correlated with UACR(P<0.05).Conclusion Serum level of 25(OH)D is decreased and that ofα1-MG is increased in the T2 DM patients with DN,both of which are closely related with the renal damage and could provide a theoretical basis for the diagnosis of early DN.