血清betatrophin水平与2型糖尿病肾病的相关性研究

Correlation between serum betatrophin level and type 2 diabetic nephropathy

目的:探讨血清betatrophin水平在2型糖尿病肾病病人的临床价值。方法:选取45名健康体检者为对照组,82例门诊及住院2型糖尿病(T2DM)病人为T2DM组。T2DM组分为3组:正常白蛋白尿组[尿白蛋白肌酐比(UACR)<30 mg/g],微量白蛋白尿组(UACR 30~300 mg/g)和大量白蛋白尿组(UACR>300 mg/g);采用酶联免疫吸附法测定血清betatrophin水平,同时检测血糖、血脂等指标。结果:T2DM病人各组的betatrophin、空腹血糖(FPG)、空腹胰岛素(FIns)、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、三酰甘油(TG)均明显高于对照组,且大量蛋白尿组betatrophin、FPG、FIns、HOMA-IR、C肽(FCP)明显高于正常白蛋白尿组(P<0.05)。T2DM组的betatrophin水平与TG(r=0.425)、UACR(r=0.319)、FPG(r=0.287)、HOMA-IR(r=0.292)显著正相关(P<0.01)。多元逐步回归分析显示betatrophin、低密度脂蛋白胆固醇是影响UACR的独立危险因素;UACR、TG是影响betatrophin的独立危险因素。结论:血清betatrophin水平在2型糖尿病肾病病人中显著升高,随着病情加重,betatrophin水平也逐渐升高,提示betatrophin可能参与了糖尿病肾病的发生发展。

Objective:To explore the clinical value of serum betatrophin level in patients with type 2 diabetic nephropathy.Methods:A total of 45 healthy outpatients were enrolled as the control group.Eighty-two patients with T2DM were set as the T2DM group,and were subdivided into the normal albuminuria group[urinary albumin creatinine ratio(UACR)<30 mg/g],microalbuminuria group(UACR at 30-300 mg/g)and macroalbuminuria group(UACR>300 mg/g).The serum level of betatrophin was measured using enzyme linked immunosorbent assay,and the levels of blood glucose and blood lipid were measured simultaneously.Results:The levels of betatrophin,FPG,FIns,HOMA-IR,HbA1c and TG in T2DM group were significantly higher than those in control group(P<0.05),and the levels of betatrophin,FPG,FIns,HOMA-IR and FCP in macroalbuminuria group were significantly higher than those in normal albuminuria group(P<0.05).The serum level of betatrophin in T2DM patients was positively correlated with the TG(r=0.425),FPG(r=0.287),UACR(r=0.319)and HOMA-IR(r=0.292)(P<0.01).The results of stepwise multiple regression analysis showed that betatrophin and LDL-C were the independent relevant factors affecting UACR,and the UACR and TG were the independent relevant factors affecting betatrophin level.Conclusions:The serum level of betatrophin in patients with type 2 diabetic nephropathy increases significantly,and gradually increases with the aggravation of the disease,which suggest that betatrophin may be involved in the occurrence and development of diabetic nephropathy.