血清脂联素与糖尿病肾病血液透析患者糖脂代谢的关系

Relationship between serum adiponectin and glucose and lipid metabolism in hemodialysis patients with diabetic nephropathy

目的探讨血清脂联素(ADPN)与糖尿病肾病(DN)血液透析患者体内糖脂代谢的相关性。方法选择2018年1月至2021年1月郑州市第一人民医院收治的行血液透析的DN患者96例为研究对象(观察组),另选择同期来院体检健康者68例作为对照组。观察组患者于治疗前、对照组受试者于体检当日采集空腹静脉血3 mL,离心取血清,采用酶联免疫吸附法检测血清脂联素水平,应用全自动生化分析仪检测总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平,采用葡萄糖氧化酶法检测空腹血糖(FBG)水平,采用高效液相色谱法检测糖化血红蛋白(HbA1c)水平,应用全自动化学发光仪检测空腹胰岛素水平(FINS)。采用Pearson相关性分析法分析血清脂联素与DN血液透析患者糖脂代谢指标的相关性。结果观察组患者的血清脂联素水平显著高于对照组(t=14.392,P<0.05)。2组受试者血清TC、LDL-C水平比较差异无统计学意义(P>0.05);观察组患者血清HDL-C水平显著低于对照组,TG、FBG、HbA1c、FINS水平显著高于对照组(P<0.05)。Pearson相关性分析结果显示,DN血液透析患者血清脂联素与HDL-C呈正相关(r=0.563,P<0.05),与FBG、FINS、TG呈负相关(r=-0.572、-0.610、-0.622,P<0.05),与TC、LDL-C、HbA1c无相关性(r=0.059、0.151、-0.038,P>0.05)。结论DN血液透析患者血清脂联素水平显著高于健康人群。血清脂联素与糖脂代谢异常具有一定的相关性,对临床判断血液透析DN患者糖脂代谢状态具有一定指导意义。

Objective To explore the correlation between serum adiponectin(ADPN)and glucose and lipid metabolism in hemodialysis patients with diabetic nephropathy(DN).Methods A total of 96 DN patients who underwent hemodialysis at the First People's Hospital of Zhengzhou from January 2018 to January 2021 were selected as the research subjects(observation group),and 68 healthy subjects who came to the hospital for physical examination during the same period were selected as the control group.About 3 mL of fasting venous blood was collected from patients in the observation group before treatment and from subjects in the control group on the day of the physical examination.The serum was obtained by centrifugation,and the serum ADPN level was detected by using the enzyme-linked immunosorbent assay;the levels of total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and triglyceride(TG)were measured by using a fully automatic biochemical analyzer;the fasting blood glucose(FBG)level was detected by using the glucose oxidase method;the glycosylated hemoglobin(HbA1c)level was detected by using the high-performance liquid chromatography;the fasting insulin(FINS)level was measured by using a fully automatic chemiluminescence apparatus.The correlation between serum ADPN levels and glucose and lipid metabolism in DN patients undergoing hemodialysis was analyzed by Pearson correlation.Results The serum ADPN level of patients in the observation group was significantly higher than that in the control group(t=14.392,P<0.05).There was no statistically significant difference in TC and LDL-C levels of subjects between the two groups(P>0.05).The serum HDL-C level of patients in the observation group was significantly lower than that in the control group,while the TG,FBG,HbA1c and FINS levels were significantly higher than those in the control group(P<0.05).Pearson correlation analysis showed that serum ADPN in DN patients undergoing hemodialysis was positively correlated with HDL-C(r=0.563,P<0.05)and negatively correlated with FBG,FINS and TG(r=-0.572,-0.610,-0.622;P<0.05),but showed no correlation with TC,LDL-C and HbA1c(r=0.059,0.151,-0.038;P>0.05).Conclusion The serum ADPN level of DN patients during hemodialysis is significantly higher than that of healthy people,which is related to abnormal glucose and lipid metabolism,and has certain significance for clinical judgment of the glucose and lipid metabolism status of DN patients receiving hemodialysis.