老年2型糖尿病肾病患者血清OPN、VEGF、Hcy与肾功能和认知功能障碍的关系分析

Analysis of the Relationship between Serum OPN,VEGF and Hcy and Renal Function and Cognitive Dysfunction in Elderly Patients with Type 2 Diabetic Kidney Disease

目的:探讨老年2型糖尿病肾病(T2DKD)患者血清骨桥蛋白(OPN)、血管内皮生长因子(VEGF)、同型半胱氨酸(Hcy)与肾功能和认知功能障碍(CD)的关系。方法:选取2017年1月~2022年6月安徽医科大学第二附属医院收治的140例T2DKD患者为T2DKD组,根据是否发生CD分为CD组41例和非CD组99例,选取60例单纯T2DM患者为T2DM组,另选取同期50名体检健康志愿者为对照组。检测血清OPN、VEGF、Hcy和计算肾功能指标[尿白蛋白/肌酐比(UACR)、估计肾小球滤过率(eGFR)]。采用Spearman相关性分析老年T2DKD患者血清OPN、VEGF、Hcy水平与肾功能指标的相关性,采用多因素Logistic回归分析老年T2DKD患者CD的影响因素。结果:对照组、T2DM组、T2DKD组血清OPN、VEGF、Hcy水平和UACR依次升高,eGFR依次降低(P<0.05)。Spearman相关性分析显示,老年T2DKD患者血清OPN、VEGF、Hcy水平与UACR呈正相关,与eGFR呈负相关(P<0.05)。多因素Logistic回归分析显示,稳态模型评估胰岛素抵抗指数(HOMA-IR)、UACR、OPN、VEGF、Hcy升高为老年T2DKD患者CD的独立危险因素,eGFR升高为独立保护因素(P<0.05)。结论:老年T2DKD患者血清OPN、VEGF、Hcy水平升高,与肾功能和CD密切相关,可能成为老年T2DKD患者CD的辅助预测指标。

Objective:To investigate the relationship between serum osteopontin(OPN),vascular endothelial growth factor(VEGF),homocysteine(Hcy)and renal function and cognitive dysfunction(CD)in elderly patients with type 2 diabetic kidney disease(T2DKD).Methods:140 patients with T2DKD who were admitted to the Second Affiliated Hospital of Anhui Medical University from January 2017 to June 2022 were selected as T2DKD group.According to the occurrence of CD,they were divided into CD group with 41cases and non-CD group with 99 cases,60 patients with simple T2DM were selected as T2DM group,and 50 healthy volunteers during the same period were selected as control group.Serum OPN,VEGF,Hcy were measured and renal function indexes[urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR)]were calculated.Spearman correlation was used to analyze the correlation between serum OPN,VEGF,Hcy levels and renal function indexes in elderly patients with T2DKD,and multivariate Logistic regression was used to analyze the influencing factors of CD in elderly patients with T2DKD.Results:Serum OPN,VEGF,Hcy levels and UACR in the control group,T2DM group and T2DKD group were increased successively,while eGFR was decreased successively(P<0.05).Spearman correlation analysis showed that serum OPN,VEGF and Hcy levels in elderly patients with T2DKD were positively correlated with UACR,and negatively correlated with eGFR(P<0.05).Multivariate Logistic regression analysis showed that homeostasis model assessment-insulin resistance(HOMA-IR),OPN,VEGF and Hcy were elevated as independent risk factors for CD in elderly patients with T2DKD,and eGFR was elevated as an independent protective factor(P<0.05).Conclusion:Elevated serum OPN,VEGF and Hcy levels in elderly patients with T2DKD are closely related to renal function and CD,and which may be an auxiliary predictor of CD in elderly patients with T2DKD.