早期糖尿病肾病患者25-羟维生素D及相关指标水平变化

Changes of 25-hydroxyvitamin D and its related indexes in patients with early diabetic nephropathy

目的观察早期糖尿病肾病(DN)患者血清25-羟维生素D、白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)水平及尿白蛋白肌酐比(UACR)变化情况。方法将2020年9月至12月在西安医学院第一附属医院肾内科住院的早期DN患者67例设为DN组。选择同期在西安医学院第一附属医院健康体检者74名设为对照组。收集两组人员的身高、体重指数和血压等一般情况,测定其空腹25-羟维生素D、IL-1β、TNF-α水平,UACR及糖脂代谢指标;分析维生素D与IL-1β、TNF-α、TC、TG水平及UACR的关系。结果DN组体重指数、空腹血糖、糖化血红蛋白水平高于对照组,差异有统计学意义(P<0.05)。DN组TC、TG、LDL-C及UACR水平高于对照组,HDL-C水平低于对照组,差异有统计学意义(P<0.05)。DN组25-维生素D水平低于对照组,差异有统计学意义(P<0.05)。DN组IL-1β、TNF-α水平均高于对照组,差异有统计学意义(P<0.05)。DN组血清25-羟维生素D水平与IL-1β、TNF-α水平及UACR呈负相关(r=-0.647、-0.783、-1.621,P<0.05)。结论早期DN患者体内血清25-羟维生素D水平较正常人降低,其水平与患者炎症因子及蛋白尿等危险因素有相关性。

Objective To observe the changes of serum 25-hydroxyvitamin D,Interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and urinary albumin creatinine ratio(UACR)in patients with early diabetic nephropathy(DN).Methods A total of 67 patients with early DN who were hospitalized in the Department of Nephrology,the First Affiliated Hospital of Xian Medical University from September to December 2020 were selected as DN group.A total of 74 healthy individuals who underwent physical examination in the First Affiliated Hospital of Xian Medical University during the same period were selected as the control group.The height,body mass index,and blood pressure of each group were collected,and the levels of fasting 25-hydroxyvitamin D,IL-1βand TNF-α,UACR and glucose and lipid metabolism indexes were measured;the relationship between vitamin D and IL-1β,TNF-α,TC,TG,and UACR were analyzed.Results The levels of body mass index,fasting blood glucose and glycosylated hemoglobin in DN group were higher than those in control group,and the differences were statistically significant(P<0.05).TC,TG,LDL-C and UACR levels in DN group were higher than those in control group,while HDL-C level was lower than control group,the differences were statistically significant(P<0.05).The level of 25-vitamin D in DN group was lower than that in control group,the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin DN group were higher than those in control group,and the differences were statistically significant(P<0.05).There was negative correlation between serum 25-hydroxyvitamin D levels and IL-1β,TNF-αlevel and UACR in DN group(r=-0.647,-0.783,-1.621,P<0.05).Conclusion The serum 25-hydroxyvitamin D level in patients with early DN is lower than that in normal person,and its level is correlated with inflammatory factors,proteinuria and other risk factors.