白细胞介素-37与2型糖尿病肾脏病的相关性分析

Correlation between interleukin-37 and diabetic kidney disease in type 2 diabetes mellitus

目的探讨白细胞介素-37(IL-37)在2型糖尿病(T2DM)及糖尿病肾脏病(DKD)患者中的表达及与DKD的相关性。方法纳入陕西省人民医院2018年12月~2019年12月住院的T2DM患者228例,根据尿白蛋白与肌酐比值(UACR)和估算肾小球滤过率(eGFR),分为正常蛋白尿(单纯DM)组80例、微量白蛋白尿(早期DKD)组76例、大量白蛋白尿(临床DKD)组72例,另选取60例门诊健康体检者作为对照组。收集各组基本资料、实验室指标,采用酶联免疫吸附(ELISA)法检测各组血清IL-37水平;分析IL-37浓度在各组间的差异及与实验室指标的相关性。结果单纯DM组、早期DKD组及临床DKD组患者血清IL-37浓度均显著高于对照组,差异有统计学意义(均P<0.05);临床DKD组IL-37浓度较早期DKD组显著升高,差异有统计学意义(P=0.043),但早期DKD组IL-37浓度与单纯DM组相比差异无统计学意义(P>0.05)。Spearman相关分析血清IL-37浓度与尿蛋白定量、尿ALB、尿α1-MG、尿β2-MG及HbA1C呈显著正相关(r分别为0.302,0.286,0.222,0.216,0.265,P<0.05),与eGFR呈显著负相关(r=-0.357,P=0.001)。Logistic回归分析提示IL-37可能是T2DM合并DKD的保护因素(OR=0.822,95%CI:0.702~0.962)。结论IL-37血清浓度与T2DM患者合并DKD的发展有关,IL-37可能成为治疗DKD的潜在新方法。

Objective To explore the expression of Interleukin-37(IL-37)in patients with type 2 diabetes mellitus complicated with diabetic kidney disease(DKD)and investigate correlation between IL-37and DKD.Methods A total of 228 patients with T2DM were included in this pilot study.According to urinary albumin to creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR),the patients were separated into three groups:normoalbuminuria(DM)group with 80 patients,microalbuminuria(early DKD)group with 76 patients and macroalbuminuria(clinical DKD)group with 72 patients.60 healthy people were selected as control group.The basic data,laboratory examination data of patients in each group were collected.Level of IL-37 in each group were detected by Enzyme-linked immunosorbent assay(ELISA),Levels of IL-37 between the study groups were examined and compared.The correlations between IL-37 concentration and laboratory examination data were analyzed.Results IL-37 concentration in DM group,early DKD and clinical DKD group were significantly higher than control group(P<0.05),and the clinical DKD group was significantly higher than the early DKD group(P=0.043).However,the concentration of IL-37 in the early DKD group was not significantly different from that of the DM group(P>0.05).Spearman correlation analysis showed that positive correlations were detected between IL-37 and 24-hours urinary protein,urinary ALB,urineα1-MG,β2-MG and HbA1C(r=0.302,0.286,0.222,0.216,0.265,respectively,P<0.05);However,a negative correlation between IL-37 and eGFR(r=-0.357,P=0.001).Logistic regression analysis suggested that IL-37 may be a protective factor for T2DM complicated with DKD(OR=0.822,95%CI:0.702-0.962).Conclusion The serum concentration of IL-37 is associated with the development of DKD in T2DM patients.IL-37 might be a potential new method for the treatment of DKD.