不同分期糖尿病肾病患者25羟维生素D、低氧诱导因子-1α检测及临床意义

Expression and significance of 25-hydroxyvitamin D and hypoxia-inducible factor-1αin patients with diabetic nephropathy in different stages

目的:探讨25羟维生素D、低氧诱导因子-1α(HIF-1α)在不同分期糖尿病肾病患者中的表达。方法:选取60例2型糖尿病肾病患者作为研究对象,依照Mogensen分期将患者分为Ⅰ-Ⅱ期组、Ⅲ期组和Ⅳ-Ⅴ期组,其中Ⅰ-Ⅱ期组15例,Ⅲ期组24例,Ⅳ-Ⅴ期组21例,对比各组患者临床检测指标、25羟维生素D及HIF-1α水平,并分析相关指标与不同分期糖尿病肾病患者的相关性。结果:三组患者空腹血糖(FPG)、血磷(P)、血钙(Ca)对比均无统计学差异(均P>0.05),三组患者糖化血红蛋白(HbA1c)、血清肌酐(Cr)指标对比均有统计学差异(均P<0.05);三组患者25羟维生素D及HIF-1α水平对比均有统计学差异(均P<0.05);Spearman相关分析结果显示:FPG、P、Ca与患者肾功能损害程度无相关性(均P<0.05),HbA1c、Cr、HIF-1α与肾功能损害程度正相关(均P<0.05),25羟维生素D与患者肾功能损害程度负相关(P<0.05);Logistic回归分析显示,25羟维生素D和HIF-1α为糖尿病肾病的独立预测指标(均P<0.05)。结论:25羟维生素D、低氧诱导因子-1α在不同分期糖尿病肾病患者中的表达差异明显,糖尿病肾病患者分期越高,25羟维生素D水平越低,糖尿病肾病患者分期越高低氧诱导因子-1α水平越高,25羟维生素D和低氧诱导因子-1α与糖尿病肾病相关,而且能够在一定程度上反应患者疾病的严重程度,可为临床诊断和预后判断提供参考。

Objective:To investigate the expression of 25-hydroxyvitamin D and hypoxia-inducible factor-1α(HIF-1α)in different stages of diabetic nephropathy.Methods:60 patients with type 2 diabetic nephropathy were selected as the research objects.According to Mogensen stage,the patients were divided into stageⅠ-Ⅱgroup(15 cases),stageⅢgroup(24 cases)and stageⅣ-Ⅴgroup(21 cases).The clinical test indicators,25-hydroxyvitamin D and HIF-1αlevels of each group were compared,and the correlation between related indicators and diabetic nephropathy in different stages was analyzed.Results:There was no significant difference in FPG,P and Ca among the three groups(all P>0.05),while there was significant difference in HbA1c and Cr among the three groups(all P<0.05).There was significant difference in 25-hydroxyvitamin D and HIF-1αamong the three groups(all P<0.05).The spearman correlation analysis showed that the FPG,P,Ca were not related to the degree of renal function damage(all P>0.05),and HbA1c,Cr and HIF-1αwere positively correlated with the degree of renal function damage(all P<0.05),and 25-hydroxyvitamin D was negatively correlated with the degree of renal function damage(P<0.05).Logistic regression analysis showed that 25-hydroxyvitamin D and HIF-1αwere independent predictors of diabetic nephropathy(all P<0.05).Conclusion:The expression of 25-hydroxyvitamin D and HIF-1αin patients with different stages of diabetic nephropathy is significantly different.The higher the stage of diabetic nephropathy,the lower the levels of 25-hydroxyvitamin D and HIF-1α.25-hydroxyvitamin D and HIF-1αare related to diabetic nephropathy,and can reflect the severity of the patient’s disease to a certain extent,which can provide references for clinical diagnosis and prognosis.