脂联素在2型糖尿病肾病患者中的变化

目的：探讨2型糖尿病肾病（DN）患者血清、尿脂联素水平变化及与血浆可溶性血栓调节蛋白（sTM）的关系。方法：根据尿白蛋白排泄率（UAER）将82例2型糖尿病患者分成糖尿病正常白蛋白尿组（DM）、微量白蛋白尿组（DN1）和大量白蛋白尿组（DN2）;应用酶联免疫吸附法（ELAISA）测定各组血清、尿中的脂联素,血浆sTM水平。结果：DN1组的血清脂联素水平高于DM组（P〈0.01）,DN2组的血清脂联素水平高于DN1组（P〈0.01）。DN1组的尿脂联素水平高于DM尿组（P〈0.05）,DN2的尿脂联素水平高于DN1组（P〈0.01）。DN1组的血浆sTM水平高于DM组（P〈0.01）,DN2组的血浆sTM水平高于DM组（P〈0.01）。血清脂联素与尿脂联素、UAER、血浆sTM呈正相关（r=0.564,0.412,0.587,P〈0.01）,与Ccr呈负相关（r=-0.362,P〈0.01）;尿脂联素与Scr、UAER、血浆sTM呈正相关（r=0.292,0.748,0.775,P〈0.01）,与Ccr（r=-0.379,P〈0.01）呈负相关。结论：2型DN患者血清、尿脂联素水平可能是反映DN早期内皮损害的重要生物标记物。

Change of Adiponectin in Type 2 Diabetic Patients with Nephropathy

Objective：To explore the relationship of adiponectin in the serum and urine and plasma soluble thrombomodulin（sTM） in type 2 diabetic patients with nephropathy.Methods：Eighty-two type 2 diabetic patients were assigned to the diabetic group（DM）,the micro-albuminuria group（DN1）,and the macro-albuminuria group（DN2） according to the urine albumin excretion rate（UAER）.Serum and urinary adiponectin and plasma sTM were detected by ELAISA.Results：Serum and urinary adiponectin level was significantly and gradually increased in accordance with the level of UAER.Plasma sTM was higher in DN1 group than in DM group.Plasma sTM was higher in DN2 group than in DN1 group.For the whole subjects,serum adiponectin was positively related to urinary adiponectin（r=-0.564,P0.01）,UAER（r=0.412,P0.01）,plasma sTM （r=0.587,P0.01） and negatively related to Ccr（r=-0.362,P0.05）;urinary adiponectin was positively related to serum creatinine （r=0.292,P0.01）,UAER（r=0.748,P0.01） and plasma sTM（r=0.775,P0.01） and negatively related to Ccr（r=-0.379,P0.01）.Conclusion：These results suggested that increased serum and urinary adiponectin might predict vascular endothelial dysfunction in diabetic patients with nephropathy.