血清高迁移率族蛋白B1与2型糖尿病患者肾损伤的相关性研究

Correlation between high mobility group protein B1 and kidney injury in patients with type 2 diabetes mellitus

目的 探讨血清高迁移率族蛋白B1(HMGB1)与T2DM患者肾损伤的相关性。方法选取2017年1月至2018年9月于中南大学湘雅三医院肾内科和内分泌科住院的T2DM患者118例,根据UACR分为正常蛋白尿组(Normo,UACR<30 mg/g,n=39),微量蛋白尿组(Micro,30≤UACR<300 mg/g,n=41)和大量蛋白尿组(Macro,UACR≥300 mg/g,n=38)。另选取同期30名体检健康者为正常对照(NC)组。检测血清HMGB1、尿肾损伤分子1(UKIM-1)、尿中性粒细胞明胶酶相关脂质运载蛋白(UNGAL)、尿视黄醇结合蛋白(URBP)及尿肌酐(Ucr)。结果 Normo、Micro、Macro组血清UKIM-1/Ucr、UNGAL/Ucr、URBP/Ucr及HMGB1依次升高(P<0.05)。Spearman相关分析显示,血清HMGB1与UACR、UKIM-1/Ucr、UNGAL/Ucr及URBP/Ucr呈正相关(P<0.01),与eGFR呈负相关(P<0.01)。Logistic回归分析显示,HMGB1升高是T2DM患者白蛋白尿的危险因素。结论 血清HMGB1与T2DM患者肾小管损伤和尿白蛋白排泄密切相关,是综合反映肾损伤进展的重要指标。

ObjectiveTo explore the relationship between high mobility group protein B1(HMGB1)and renal injury in patients with type 2 diabetes mellitus(T2DM).MethodsA total of 118hospitalized patients with T2DM were enrolled in this study from The Nephropathy and Endocrinology Department of The Third Xiangya Hospital of Central South from January 2017 to September 2018. All the patients were divided into three groups:Normo group(UACR<30 mg/g,n=39),Microgroup(30≤UACR<300 mg/g,n=41)and Macro group(UACR≥300 mg/g,n=38)according to the UACR. Healthy volunteers were selected as control group(n=30). Serum HMGB1,UKIM-1,UNGAL,URBP and Ucr were measured.ResultsUKIM-1/Ucr,UNGAL/Ucr,URBP/Ucr and serum HMGB1 increased gradually in Normo,Micro and Macro groups. Spearman correlation analysis showed that serum HMGB1 levels were positively correlated with both UACR and renal injury indicators(P<0. 01),and negatively correlated with eGFR(P<0. 01). Logistic regression analysis showed that the increase of HMGB1 was a risk factor for the progression of albuminuria in T2DM patients.ConclusionHMGB1 is closely related to progression of proteinuria and renal tubular damage in patients with T2DM. It is an important indicator which can comprehensively reflects the progression of DKD.