糖尿病肾病患者肾素、血管紧张素Ⅱ、醛固酮与维生素D水平的相关性分析

Correlation of the vitamin D level with renin,angiotensinⅡand aldosterone in patients with diabetic nephropathy

目的分析维生素D、肾素、血管紧张素Ⅱ及醛固酮在糖尿病肾病发生发展中的水平变化及相关性。方法收集181例糖尿病患者及49例健康对照者的临床资料,糖尿病患者根据尿白蛋白/肌酐(ACR)分为3组:正常蛋白尿组56例(ACR<30μg/mg)、微量蛋白尿组66例(ACR 30μg/mg^299μg/mg),临床蛋白尿组59例(ACR>299μg/mg)。分析患者维生素D、肾素(PRA)、血管紧张素Ⅱ(ATⅡ)及醛固酮(ALD)的水平。结果与对照组比较,糖尿病患者组PRA、ATⅡ、ALD均显著升高,维生素D均显著降低(P<0.05)。组间两两比较维生素D、PRA、ATⅡ、ALD差异均有统计学意义(P<0.05)。相关性分析显示,PRA、ATⅡ、ALD与维生素D水平均呈负相关(r值分别为-0.672、-0.631、-0.589,P<0.05)。Logistic回归分析提示,维生素D是糖尿病肾病的保护因素(P<0.05)。结论糖尿病肾病患者维生素D、肾素、血管紧张素Ⅱ及醛固酮水平变化与DN的发生、发展密切相关,维生素D是其保护因子。

Objective To investigate the correlation of vitamin D level with renin,angiotensinⅡand aldosterone in the development of diabetic nephropathy.Methods Clinical data of 181 diabetic patients and 49 healthy controls were collected.According to urinary albumin/creatinine(ACR),diabetic patients were divided into 3 groups:56 patients with normal proteinuria(ACR<30 g/mg),66 patients with microproteinuria(ACR 30 g/mg-299 g/mg),and 59 patients with clinical proteinuria(ACR>299 g/mg).The levels of vitamin D,renin(PRA)and angiotensinⅡ(ATⅡ)and aldosterone(ALD)were analyzed.Results Compared with the control group,PRA,ATⅡ,ALD of diabetes group increased significantly,vitamin D decreased significantly(P<0.05).Between vitamin D,PRA,ATⅡ,ALD of the two groups,the differences were statistically significant(P<0.05).Correlation analysis showed that PRA,ATⅡ,ALD with vitamin D levels are negatively correlated(r=-0.672,r=-0.631,r=-0.589,P<0.05).Logistic regression analysis indicated that vitamin D was a protective factor for diabetic nephropathy(P<0.05).Conclusion Vitamin D,renin,angiotensinⅡand aldosterone levels are closely related to the occurrence and development of DN.Vitamin D is the protective factor.