2型糖尿病患者尿蛋白水平与血清白细胞介素1β和晚期蛋白氧化产物的关系

目的观察不同尿白蛋白排泄率（UAER）的2型糖尿病患者血清白细胞介素18（IL-1β）和晚期蛋白氧化产物（AOPP）水平，探讨其在糖尿病蛋白尿发生和发展中的作用。方法选择2008年11月至2010年2月在我院住院的2型糖尿病患者62例，按照UAER水平分组：间断白蛋白尿组（n=20），UAER〈20μg／min；微量白蛋白尿组（n=22），UAER20-200μg／min；临床白蛋白尿组（n=20），UAER〉200μg／min。选择同期健康体检者20例作为对照组。比较各组血清IL-1μ和AOPP水平。结果3组糖尿病患者血清IL-1β和AOPP水平均高于对照组（P〈0．05），微量白蛋白尿组IL-1β和AOPP水平均高于正常白蛋白尿组（P〈0．05），显性白蛋白尿组IL-1β和AOPP水平均高于微量白蛋白尿组和正常白蛋白尿组（P〈0．01）。血清IL-1β与AOPP呈正相关（r=0．760，P〈0．01），血清IL-1β和AOPP与UAER呈正相关（r分别为0．809和0．813，P〈0．01）。结论IL-1β和AOPP可作为糖尿病肾脏微血管病变的早期预测因子，对预防糖尿病肾脏微血管病变有重要意义。

Relationship between urinary protein and the serum level of IL-1β,AOPP in type 2 diabetic mellitus

Objective To observe the changes of serum levels of interleukin-1β （IL-1β） and advanced oxidative protein products （AOPP） in type 2 diabetic mellitus patients with different urine albumin excretion rate （UAER）, and their roles in the development and progression of proteinuria. Methods Sixty-two patients with type 2 diabetic mellitus from Nov. 2008 to Feb. 2010 were divided into three groups according to UAER： interrupt albuminuria group （n = 20）, UAER〈20 μg/min; micmamount albuminuria group （n = 22）, UAER 20-200μg/min; clinical albuminuria group （n = 20） ： UAER〉200μg/min. Twenty healthy examination subjects at the same period were selected as control group. The serum level of IL-1β and AOPP were compared among four groups. Results The serum levels of IL-1β and AOPP in three type 2 diabetic mellitus groups were higher than control group （P〈0. 05）. The serum levels of IL-1β and AOPP in the microamount albuminuria group was higher than normal albuminuria group （P〈0. 05） and those in the dominancy albuminuria group was higher than microamount albuminuria and normal albuminuria groups （P〈0. 01 ）. The serum levels of IL-1β were positively correlated to the serum levels of AOPP （r = 0. 760, P〈 0. 01） ,and the serum levels of IL-1β and AOPP were positively correlated to UAER （r= 0. 809,0. 813,P〈0. 01 ）. Conclusions IL-1β and AOPP can be early predictions of renal micmangiopathy in diabetic mellitus and play an important role to prevent renal microangiopathy.