2型糖尿病患者血清淀粉样蛋白A的表达及与糖尿病肾病的关系

Expression of serum amyloid A in patients with type 2 diabetes mellitus and its correlation to diabetic nephropathy

目的探讨2型糖尿病患者血清淀粉样蛋白A(SAA)的表达及与糖尿病肾病(DN)的关系。方法257例2型糖尿病患者作为研究对象,根据尿白蛋白与尿肌酐比(UACR)分为单纯糖尿病组(UACR<30 mg/g,172例)和早期DN组(UACR为30~300 mg/g,85例),选取同期体检健康者98例作为正常对照组。采集一般资料,检测血糖、血脂、糖化血红蛋白(HbA1c)、SAA、UACR。比较三组一般资料、SAA、UACR,分析2型糖尿病患者SAA与UACR相关性。结果三组研究对象性别、年龄、收缩压、舒张压、甘油三酯、总胆固醇、高密度脂蛋白胆固醇比较,差异均无统计学意义(P>0.05);三组研究对象空腹血糖、糖化血红蛋白、低密度脂蛋白胆固醇比较,差异均有统计学意义(P<0.05);单纯糖尿病组和早期DN组患者空腹血糖、低密度脂蛋白胆固醇比较,差异均无统计学意义(P>0.05);单纯糖尿病组和早期DN组患者糖化血红蛋白及病程比较,差异有统计学意义(P<0.05)。单纯糖尿病组、早期DN组、正常对照组SAA分别为(5.29±1.07)、(16.43±2.90)、(2.81±0.50)mg/L,UACR分别为(15.07±5.81)、(69.01±15.4)、(6.19±2.4)mg/g,三组SAA、UACR比较,差异均有统计学意义(P<0.05)。且早期DN组SAA、UACR高于单纯糖尿病组,差异均具有统计学意义(P<0.05)。Pearson相关性分析表明,2型糖尿病患者SAA与UACR呈正相关(r=0.497,P<0.01)。结论2型糖尿病和DN的发生与SAA有关,随着UACR的升高,SAA也升高,SAA可作为反映早期DN的重要检测指标。

Objective To discuss the expression of serum amyloid A(SAA)in patients with type 2 diabetes mellitus and its correlation to diabetic nephropathy(DN).Methods A total of 257 patients with type 2 diabetes mellitus as study subjects were divided into simple diabetes group(UACR<30 mg/g,172 cases)and early DN group(UACR 30-300 mg/g,85 cases)according to the value of urine albumin to creatinine ratio(UACR).Another 98 healthy subjects were selected as normal control group.The general data was collected,and blood glucose,blood lipids,glycosylated hemoglobin(HbA1c),SAA,UACR were detected.The general information,SAA and UACR levels of the three groups were compared,and the correlation between SAA and UACR was analyzed.Results There was no statistically significant difference in gender,age,systolic blood pressure,diastolic blood pressure,triglyceride,total cholesterol,high density lipoprotein cholesterol among the three groups(P>0.05).There was statistically significant difference in fasting blood glucose,glycosylated hemoglobin and low-density lipoprotein cholesterol among three groups(P<0.05).There was no statistically significant difference in fasting blood glucose,low-density lipoprotein cholesterol between simple diabetes group and early DN group(P>0.05).There was statistically significant difference in glycosylated hemoglobin and course of disease between simple diabetes group and early DN group(P<0.05).The SAA of simple diabetes group,early DN group and normal control group were(5.29±1.07),(16.43±2.90),(2.81±0.50)mg/L,and UACR were(15.07±5.81),(69.01±15.4),(6.19±2.4)mg/g.There was statistically significant difference in SAA and UACR among three groups(P<0.05).The SAA and UACR of early DN group were higher than those of simple diabetes group,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that SAA was positively correlated to UACR in patients with type 2 diabetes mellitus(r=0.497,P<0.01).Conclusion The occurrence of type 2 diabetes mellitus and DN is correlated to SAA.With the increase of UACR,SAA also increases.SAA can be used as an important indicator of early DN.