血清TLR2、TLR4水平与2型糖尿病肾病患者肾功能及炎症状态的关系分析

Analysis of the relationship between serum TLR2 and TLR4 levels and renal function and inflammatory status in patients with type 2 diabetic nephropathy

目的分析血清toll样受体2(TLR2)、toll样受体4(TLR4)水平与2型糖尿病肾病(DKD)患者肾功能及炎症状态的关系。方法选取2017年1月至2020年1月本院收治的120例2型糖尿病(T2DM)患者为研究对象,根据尿白蛋白排泄率(UAER)分为单纯T2DM组(UAER<20μg/min,n=40)、早期DKD组(20μg/min≤UAER<200μg/min,n=50)和临床DKD组(UAER≥200μg/min,n=30),同时选取同期于本院进行体检的40例健康者作为对照组,检测各组血清TLR2、TLR4水平、肾功能指标[血肌酐(Scr)、24 h尿微量白蛋白尿(24 h UMA)、尿素氮(BUN)]和炎症状态[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)],分析血清TLR2、TLR4水平与Scr、24 h UMA、BUN、hs-CRP、TNF-α、IL-6及IL-8水平的相关性。结果单纯T2DM组、早期DKD组、临床DKD组及对照组的性别、年龄、病程及体重指数比较差异无统计学意义(P>0.05)。血清TLR2、TLR4、Scr、24 h UMA、BUN水平比较结果:临床DKD组>早期DKD组>单纯T2DM组>对照组,差异具有统计学意义(P<0.05)。血清hs-CRP、TNF-α、IL-6及IL-8水平比较结果:临床DKD组>早期DKD组>单纯T2DM组>对照组,差异具有统计学意义(P<0.05)。Spearman相关分析显示,血清TLR2、TLR4水平与Scr、24 h UMA、BUN、4h UMA、BUN、hs-CRP、TNF-α、IL-6及IL-8水平呈正相关(P<0.05)。结论 DKD患者血清TLR2、TLR4水平升高,肾功能指标和炎性因子升高,且血清TLR2、TLR4水平与肾功能及炎症状态呈正相关性。

Objective To analyze the relationship between serum TLR2 and TLR4 levels and renal function and inflammatory status in patients with type 2 diabetic nephropathy(DKD). Methods A total of 120 patients with type 2 diabetes(T2 DM)who were admitted to our hospital from January 2017 to January 2020 were selected as the research subjects. According to the urine albumin excretion rate(UAER),they were divided into the simple T2 DM group(UAER < 20μg/min,n=40),the early DKD group(20μg/min≤UAER <200μg/min,n=50)and the clinical DKD group(UAER≥200μg/min,n= 30). At the same time,select those who have undergone physical examination in our hospital during the same period 40 healthy people served as the control group to detect serum TLR2,TLR4 levels,renal function indicators[serum creatinine(Scr),24 h urine microalbuminuria(24 h UMA),urea nitrogen(BUN)]and inflammation status[ High-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)]. The correlation between serum TLR2 and TLR4 levels and Scr,24 h UMA,BUN,hs-CRP,TNF-α,IL-6 and IL-8 levels were analyzed. Results There was no statistically significant difference in gender,age,course of disease and body mass index between the T2 DM group alone,the early DKD group,the clinical DKD group and the control group(P>0.05). Serum TLR2,TLR4,Scr,24 h UMA,BUN level comparison results:clinical DKD group > early DKD group > T2 DM group > control group,the difference was statistically significant(P<0.05). Comparison of serum hs-CRP,TNF-α,IL-6 and IL-8 levels:clinical DKD group > early DKD group >T2 DM group > control group,the difference was statistically significant(P<0.05). Spearman correlation analysis showed that serum TLR2 and TLR4 levels were positively correlated with Scr,24 h UMA,BUN,4 h UMA,BUN,hs-CRP,TNF-α,IL-6 and IL-8 levels(P<0.05). Conclusion Serum TLR2 and TLR4 levels in patients with DKD increased,renal function indicators and inflammatory factors increased,and serum TLR2 and TLR4 levels were positively correlated with renal function and inflammation.