糖尿病肾病患者血清25-羟维生素D和血脂与血清胎球蛋白A表达及相关性

Expression and correlation of serum 25-hydroxyvitamin D,blood lipids and serum fetuin A in patients with diabetic nephropathy

目的分析糖尿病肾病(DN)患者血清25-羟维生素D[25-(OH)D]、血脂和血清胎球蛋白A(AHSG)表达及相关性。方法回顾性分析2017年4月~2019年6月本院收治的112例DN患者,根据其尿蛋白/肌酐值(ACR)分为正常尿蛋白组(n=42)、微量蛋白组(n=36)、大量蛋白尿组(n=34);另选同期在本院体检健康者36例为健康组、单纯糖尿病者36例为糖尿病组。比较不同人群以及不同含量蛋白尿DN患者25-(OH)D、AHSG、血脂表达关系,分析25-(OH)D、AHSG、血脂与糖尿病肾病的相关性。结果随着病情的进展,25-(OH)D、AHSG水平逐渐降低,血脂指标(胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C))逐渐上升(P<0.05),且25-(OH)D与AHSG、ACR呈正相关,与TC、TG、LDL-C呈负相关(P<0.05);TC、TG、LDL-C与AHSG呈负相关,与ACR呈正相关(P<0.05),进一步Logistic分析结果显示,25-(OH)D缺乏、AHSG降低、LDL-C升高、ACR增加为危险DN发生的独立影响因素(P<0.05)。结论25-(OH)D、AHSG、血脂与DN患者病情发展存在相关性,在糖尿病早期可检测患者25-(OH)D、AHSG、血脂水平,控制血糖、及时补充维生素D可延缓DN的发生与进展。

Objective To analyze the expression and correlation of serum 25-hydroxyvitamin D(25(OH)D),blood lipids and serum fetuin A(AHSG)in patients with diabetic nephropathy(DN).Methods 112 patients with DN treated in our hospital from April 2017 to June 2019 were retrospectively analyzed.According to the urinary protein/creatinine value(ACR),they were divided into normal urinary protein group(42 cases),microurinary protein group(36 cases)and large urinary protein group(34 cases).Another 36 healthy patients underwent physical examination in our hospital in the same time were selected as the healthy group.36 patients were selected as simple diabetes group.The expression relationships between 25(OH)D,AHSG,and lipids in different people and patients with different levels of proteinuria DN were compared.The correlation between 25(OH)D,AHSG,blood lipids and diabetic nephropathy was analyzed.Results As the disease progressed,the levels of 25(OH)D and AHSG gradually decreased,and the lipid indicators(TC,TG,LDL-C)gradually increased(P<0.05),and 25(OH)D was positively correlated with AHSG and ACR,and negatively correlated with TC,TG,and LDL-C(P<0.05).TC,TG and LDL-C were negatively correlated with AHSG,and positively correlated with ACR(P<0.05).Further Logistic research results showed that the deficiency of 25(OH)D,the decreasing of AHSG,the increasing of LDL-C,and the increasing of ACR were independent influencing factors affecting the occurrence of DN(P<0.05).Conclusion 25(OH)D,AHSG,and blood lipids are related to the development of DN in patients.In the early stage of diabetes,25(OH)D,AHSG,and blood lipid levels can be detected,blood glucose control,and timely supplementation of vitamin D can delay the occurrence and development of DN.