维生素B1水平与糖尿病肾病进展的关联性分析

目的：检测2型糖尿病患者血浆、红细胞及尿液中维生素B1水平，分析其与糖尿病肾病进展的关联性，阐明2型糖尿病肾病的代谢营养机制。方法：根据尿微量白蛋白水平将90例2型糖尿病患者分为糖尿病无肾病组（NDN组）、早期肾病组（EDN组）和临床肾病组（CDN组），每组30例；30名志愿者作为正常对照组（NC组），采用高效液相色谱法（HPLC）测定其血浆、红细胞及尿液中维生素B1的水平，分析尿微量白蛋白与血浆维生素B1水平的相关性。结果：NC组血浆维生素B1水平为(7.1±3.3) μg?L-1，NDN组、EDN组和CDN组血浆维生素B1水平分别是(4.0±2.3)、(3.1±1.0)和(2.3±0.6) μg?L-1，3组较正常组分别下降了43.7%、56.3%和67.6% (P<0.05)。NC组、NDN组、EDN组和CDN组尿液中维生素B1排泄量分别是(2.9±0.8)、(9.0±4.7)、(11.7±3.9)和(15.6±5.0) μg?L-1，3组较正常组分别增加了2、3和4.4倍（P<0.05）。尿微量白蛋白与血浆维生素B1水平呈负相关关系(r =－0.62,P=0.013)。结论：2型糖尿病患者肾病早期即发生维生素B1缺乏，且与肾病的进展密切关联，补充维生素B1可能有助于改善糖尿病肾病患者的病情。

Analysis on correlation of vitamin B1 level with progression of diabetic nephropathy

Objective To measure the vitamin B1 levels in plasma,erythrocytes and urine of the patients with type 2diabetes,and to analyze the correlation of vitamin B1 level with the progression of diabetic nephropathy,and to clarify the metabolism of nutrtion mechanism of type 2diabetic nephropathy.Methods Total 90 patients with type2 diabetes and 30 healthy volunteers were recruited.According to the levels of microalbuminuria,the patients with type 2diabetes were divided into non diabetic nephropathy(NDN)group,early diabetic nephropathy(EDN)group and clinical diabetic nephropathy(CDN)group(n=30);the healthy people was used as normal control(NC)group.The vitamin B1 levels in the plasma,erythrocytes and urine were examined with high performance liquid chromatography(HPLC).The correlation of microalbuminuria with the plasma viamin B1 level was analyzed.Results The level of vitamin B1 in plasma of the patients in NC group was(7.1±3.3)μg·L-1,while it was(4.0±2.3)μg·L-1 in NDN group,(3.1±1.0)μg·L-1 in EDN group and(2.3±0.6)μg·L-1 in CDN group.Compared with NC group,the vitamin B1 levels in the plasma in NDN,EDN and CDN groups dropped 43.7%,56.3%,and 67.6%,respectively(P<0.05).The excretion of vitamin B1 in urine were(2.9±0.8),(9.0±4.7),(11.7±3.9),and(15.6±5.0)μg·L-1 in NC group,NDN group,EDN group and CDN group,respectively.Compared with NC group,the vitamin B1 levels in the urine in NDN,EDN and CDN groups were increased by 2,3and 4times,respectively(P<0.05).A negative correlation was found between the level of microalbuminuria and the level of vitamin B1 in plasma(r=-0.62,P =0.013).Conclusion Vitamin B1 deficiency can be observed in the early stage of diabetic nephropathy,and the level of vitamin B1 is closely correlated with the progression of diabetic nephropathy.