糖尿病肾病血清抵抗素与胰岛素抵抗的相关性研究

目的探讨糖尿病肾病（DN）患者血清抵抗素水平及与胰岛素抵抗（IR）的关系。方法63例T2DM患者随机分为3组：依据尿微量蛋白排泄率分为A组正常白蛋白尿组（UAER〈30mg／24h）20例，B纽微量白蛋白尿组（30mg／24h≤UAER〈300mg／24h）22例，c组临床蛋白尿组（UAER≥300mg／24h）21例。D组为健康体检的正常对照组，共21例。分别检测各组的血清抵抗素、空腹血糖（FPG）、空腹胰岛素（Fins）及胰岛素抵抗指数（Homa—IR）、低密度脂蛋白（LDL—C）、内生肌酐清除率（Ccr），分析血清抵抗素水平与各检测指标的相关性。结果与正常对照组（D组）比较，A、B、C组的血清抵抗素、UAER、LDL-C、HbA1c、Homa—IR均明显升高（P均〈0．05），而Ccr显著降低（P〈0．05）。B组、C组与A组比较，血清抵抗素、UAER、LDL-C、HbA1c、Homa—IR的水平均显著升高（P均〈0．05），而Ccr显著降低（P〈0．05）。相关分析显示，DM组中，Resistin与Homa—IR、UAER、LDL-C、HbA1C均呈显著正相关（P〈0．05），与Ccr呈负相关（P〈0．05）。结论血清抵抗素与DN患者的胰岛素抵抗密切相关，检测T2DM患者的血清抵抗素变化，在一定程度上可反映其肾脏病变。

Assosciation between Serum Resistin Levels and the Insulin Resistance in Patients with Diabetic Nephropathy

Objective To investigate the relationship between the Serum Resistin levels and insulin resistance（IR） in patients with Diabetic Nephropathy（DN）. Methods The study was performed on 63 patients of T2DM and they were randomly divided into three groups based on urine protein.excretion rate. As follows, A-group, normal albuminuria group（UAER〈30mg/24h） including 20 patients. B-group, microalbuminuria group（30mg/24h〈UAER〈300mg/24h） including 22 patimts. C-group, clinical proteinuria（UAER≥ 300mg/24h） including 21patients. D-group, the normal healthy control group including 21patients. Each group was measured in Serum Resistin, fasting plasma glucose（FPG）, fasting insulin（Fins） and insulin resistance index（Homa-IR）, low density lipoprotein（LDL-C）, endogenous creatinine clearance rate（ecr）, and to analyze correlation between Serum Resistin and every index level. Results Compared with the control group（D-group）, the levels of Serum Resistin, LDL-C, UAER, HbAlc, Homa-IR significantly increased in A, B,C groups（P all 〈0.05）, but Ccr significantly reduced（P〈0.05）. Compared with A group, the levels of Serum Resistin, LDL-C, UAER, HbAlc, Homa-IR significantly increased in B and C groups（P all 〈0.05）, but Ccr significantly reduced（P〈0.05）. Correlation analysis showed that the levels of Serum Resistin in type 2 diabetic patients with nephropathy were positively correlated with the levels of LDL-C, UAER, HbAlc and Homa-IR（P〈0.05）, but it was negatively correlated with Ccr（P〈0.05）. Conclusion The levels of Serum Resistin in patients with DN is closely related to Homa-IR, detecting the changes of Serum Resistin in type 2 diabetic patients could reflect their kidney disease in some extent.