初诊2型糖尿病患者血清Toll样受体4与血尿酸水平及肌酐清除率的关系

The relationship between the level of serum toll-like receptor 4 and serum uric acid with the creatinine clearance rate in patients with newly diagnosed type 2 diabetes

目的:初步探究初诊2型糖尿病患者Toll样受体4(TLR4)与血尿酸水平及肌酐清除率的关系。方法:选择新诊断的2型糖尿病患者102例(男性/女性:54/48),采用Cockcroft-Gault公式估计肌酐清除率,使用Pearson相关分析TLR4与血尿酸及肌酐清除率的关系,再进行多元逐步回归分析。结果:(1)高尿酸组肌酐、血尿酸、总胆固醇(TC)、甘油三酯(TG)水平明显高于非高尿酸组(P<0.05);(2)患者血清TLR4与FPG(r=0.218;P<0.05)、血尿酸(r=0.302;P<0.05)呈正相关;血尿酸与体重(r=0.206;P<0.05)肌酐(r=0.46;P<0.05)、甘油三酯(r=0.481;P<0.05)、总胆固醇(r=0.242;P<0.05)呈正相关;与肌酐清除率(r=-0.246;P<0.05)呈负相关;(3)多元回归分析显示,总胆固醇、血尿酸进入以TLR4为因变量的回归方程;年龄、总胆固醇、甘油三酯、血尿酸进入以肌酐清除率为因变量的回归方程。结论:2型糖尿病者血清TLR4水平与血尿酸呈显著正相关。血尿酸是TLR4的独立影响因素,可能参与了糖尿病肾病的发生、发展。

Objective: To explore the relationship of serum uric acid level and Toll- like receptor 4 with creatinine clearance rate in patients with type 2 diabetic. Methods: 102 patients with type 2 diabetes in the first affiliated hospital of Jiamusi University were selected. Creatinine clearance rate was estimated by Cockcroft- Gault equation. The relationship between TLR4,serum uric acid and creatinine clearance rate analyzed by Pearson correlation analysis and multiple stepwise regression analysis. Results: 1 Serum uric acid,total cholesterol( TC),triglyceride( TG) levels were significantly higher in the high uric acid group than those in the non high uric acid group. 2Single- factor correlation analysis showed that TLR4 was positively correlated with FPG,SUA( P < 0. 05).Weight,Creatinine,TG,TC were positively correlated with SUA( P < 0. 05). And SUA was negatively correlated with Ccr( P < 0. 05). 3Multivariate regression analysis showed that total cholesterol,serum uric acid entered the regression equation with TLR4 as the dependent variable and Age. Total cholesterol,triglyceride,serum uric acid entered the regression equation with the creatinine clearance rate as the dependent variable. Conclusion: The level of serum TLR4 in patients with type 2 diabetes mellitus was significantly positive correlated with serum uric acid.Serum uric acid is an independent factor of TLR4,which may be involved in the occurrence and development of diabetic nephropathy.