2型糖尿病患者血清重组人信号素3a与肾小球滤过率相关性的研究

Relationship between serum Semaphorin 3a and glomerular filtration rate in patients with type 2 diabetes mellitus

目的探讨T2DM患者血清重组人信号素3a(Sema3a)与eGFR的相关性。方法选取2017年2月至2018年5月于蚌埠医学院第一附属医院内分泌科就诊的T2DM患者144例,根据eGFR分为≥90 ml/(min·1.73 m^(2))的单纯T2DM组(n=58)、60≤eGFR<90 ml/(min·1.73 m^(2))的轻度DKD组(MDKD,n=27)和<60 ml/(min·1.73 m^(2))的重度DKD组(SDKD,n=59),检测各组生化指标。结果SDKD、MDKD组Sema3a水平高于T2DM组[(83.32±21.42)vs(78.41±20.59)vs(67.57±12.54)ng/ml,P<0.05]。多元线性逐步回归分析显示,HbA1c、24 hUAlb、DBP是Sema3a的影响因素。Logistic回归分析显示,Sema3a、DBP、TG、HbA1c是eGFR的影响因素。结论T2DM患者Sema3a水平升高,是eGFR降低的危险因素,Sema3a可作为T2DM患者肾脏病变进展筛查指标。

Objective To explore the relationship between Semaphorin 3 a(Sema3 a)and glomerular filtration rate(GFR)in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 144 patients with T2 DM were enrolled in this study from the clinic of Endocrinology department in The First Affiliated Hospital of Bengbu Medical College from February 2017 to May 2018.All the patients were divided into three groups according to their eGFR:T2 DM group[T2 DM,eGFR≥90 ml/(min·1.73 m^(2)),n=58],mild diabetic nephropathy group[MDKD,60≤eGFR<90 ml/(min·1.73 m^(2)),n=27]and severe diabetic nephropathy group[SDKD,eGFR<60 ml/(min·1.73 m^(2)),n=59].Clinical and biochemical parameters were tested among the three groups.Results Serum Sema3 a level was higher in MDKD and SDKD groups than in T2 DM group[(83.32±21.42)vs(78.41±20.59)vs(67.57±12.54)ng/ml,P<0.05].Multiple linear stepwise regression analysis showed that HbA1 c,24 h UAlb and DBP were influencing factors for Sema3 a.Logistic regression analysis showed that Sema3 a,DBP,TG and HbA1 c were the influencing factors for eGFR.Conclusion Serum Sema3 a level was increased in patients with T2 DM.It was a risk factor for decreased e GFR,and may be used as a screening indicator for the development of diabetic nephropathy.