糖尿病肾脏疾病患者血清C1q肿瘤坏死因子相关蛋白9、C1q肿瘤坏死因子相关蛋白12水平变化研究

Serum CTRP9 and CTRP12 levels in patients with diabetic kidney disease

目的探讨DKD患者血清C1q肿瘤坏死因子相关蛋白9(CTRP9)和12(CTRP12)水平的变化及临床意义。方法选取2018年10月至2019年11月于我院内分泌科住院的T2DM患者161例,根据UACR分为单纯T2DM组(T2DM,n=71)、微量白蛋白尿组(MAU,n=60)及大量蛋白尿组(CAU,n=30);同期另选取本院体检中心年龄、性别相匹配的健康体检人群70名为正常对照组(NC)。检测各组血清CTRP9、CTRP12水平并进行比较分析。结果NC、T2DM、MAU及CAU组血清CTRP9、CTRP12逐渐降低[(182.79±48.05)vs(143.10±45.0)vs(115.87±58.90)vs(81.34±40.47)ng/ml(,3.97±1.22)vs(2.63±1.19)vs(2.33±1.14)vs(1.79±1.19)ng/ml,P<0.05]。Spearman相关分析显示,CTRP9与eGFR呈正相关(r=0.228,P<0.05),与DM病程、BMI、SBP、FPG、HbA1c、TG、TC、FIns、HOMA-IR、UACR呈负相关(P<0.05);CTRP12与HDL-C呈正相关(P<0.05),与BMI、HbA1c、TG及UACR呈负相关(P<0.05)。多元逐步回归分析显示,CTRP9是T2DM患者UACR的独立影响因素(P<0.05)。Logistic回归分析显示,低水平CTRP9增加T2DM患者发生DKD的风险(P<0.05)。结论DKD患者血清CTRP9、CTRP12明显降低;低水平CTRP9可能参与DKD的发生发展。

Objective To investigate serum CTRP9 and CTRP12 levels and the clinical value in patients with type 2 diabetes mellitus(T2 DM)and diabetic kidney disease(DKD).Methods A total of161 patients with T2 DM were enrolled in this study form October 2018 to November 2019 in our hospital.All the patients were divided into three groups:T2 DM group(n=71),microalbuminuria(MAU)group(n=60)and macroalbuminuria(CAU)group(n=30)according to their urinary albumin to creatinine ratio(UACR).In addition,age and sex matched healthy people were recruited from the physical examination center of our hospital as the normal control(NC)group(n=70).Serum CTRP9 and CTRP12 were tested in all the subjects.Results Serum CTRP9 level gradually decreased from NC group,T2 DM group,MAU group to CAU group[(182.79±48.05)vs(143.10±45.0)vs(115.87±58.90)vs(81.34±40.47)ng/ml,P<0.05].CTRP12 levels were significantly lower in T2 DM group,MAU group and CAU group than in NC group[(3.97±1.22)vs(2.63±1.19)vs(2.33±1.14)vs(1.79±1.19)ng/ml,P<0.05].CTRP12 level was significantly decreased in CAU group than in T2 DM group and MAU group(P<0.05).The serum CTRP9 concentration was positively correlation with eGFR,while negatively correlated with diabetes duration,BMI,SBP,FPG,HbA1c,TG,TC,FIns,HOMA-IR and UACR(P<0.05).The serum CTRP12 concentration was positively correlation with HDL-C,and negatively correlated with BMI,HbA1c,TG and UACR(P<0.05).Multiple stepwise regression analysis showed that the levels of CTRP9 were independent influencing factors for UACR.Logistic regression analysis indicated that low level of serum CTRP9 was a risk factor for the development of DKD in T2 DM.Conclusion Serum CTRP9 and CTRP12 levels were significantly decreased in patients with DKD,and the decrease of serum CTRP9 level may be involved in the progression of DKD.