早期糖尿病肾病血清 NGAL与致动脉硬化指数的关系

目的观察在早期糖尿病肾病(DN)患者血清中性粒细胞明胶酶相关载脂蛋白(NGAL)水平的变化,探讨NGAL与致动脉硬化指数(AIP)的关系。方法选取尿微量白蛋白/肌酐300 mg/g的糖尿病患者120例为糖尿病组,根据尿微量白蛋白/肌酐分为正常白蛋白尿组和早期DN组,另选取健康体检者60例作为对照组。检测各组血清甘油三酯(TG)、胆固醇(CHOL)、高密度脂蛋白(HDL)、NGAL、超敏C反应蛋白(hs-CRP)等,并计算致动脉硬化指数;分析3组NGAL、hs-CRP、AIP的变化。按照AIP三分位数将所有研究对象分成低、中、高水平3组,分析其NGAL和hs-CRP的变化。对所有变量进行简单线性相关和多元线性逐步回归分析。结果与对照组比较,正常白蛋白尿组和早期DN组NGAL、hs-CRP、AIP水平明显升高(P0.001);与正常白蛋白尿组比较,早期DN组NGAL、hs-CRP、AIP水平明显升高(P0.001)。血清NGAL水平随AIP上升而明显上升(P0.001)。AIP与hsCRP、NGAL呈正相关(r=0.296,0.313,P0.05);NGAL、hs-CRP为AIP的独立影响因素。结论血清NGAL是监测糖尿病早期肾损伤的指标。NGAL是一个急性时相反应蛋白,参与了糖尿病肾病动脉粥样硬化的发生发展。

The relationship between serum neutrophil gelatinase associated lipocalin and atherogenic index of plasma in diabetic nephropathy

Aim To investigate the clinical value of neutrophil gelatinase-associated lipocalin (NGAL) for the early diabetic nephropathy(DN), and further explore the relationship of NGAL and atherogenic index of plasma. Methods 120 cases of patients with diabetes mellitus were divided into 2 groups according to the urinary albumin creatinine ratio(UA/Cr). In addition, there is a control group including 60 cases of healthy subjects. NGAL, hypersensitive c-reactive protein (hs-CRP) and lipid related indicators of all cases were measured and the atherogenic index of plasma (AIP) was calculated. The changes of NGAL, hs-CRP, AIP were compared and analyzed. All cases were divided into three groups according to the three digits of AIP. The changes of NGAL and hs-CRP were analyzed. Simple linear correlation and multiple linear regression analysis were performed for all variables. Results The level of NGAL, AIP and hs-CRP in normal albuminuria group and DN group was significantly increased compared with control group(P<0.001). The level of NGAL, AIP and hs-CRP in DN group was significantly increased compared with normal albuminuria group(P<0.001).Serum NGAL level increased obviously as the rise of the AIP three digits. AIP were positively correlated with hs-CRP and NGAL(r=0.296, 0.313, P<0.05). Independent influencing factors for AIP were NGAL and hs-CRP. Conclusion NGAL is an index for early DN. NGAL is an acute phase reaction protein which is involved in the development of atherosclerosis in diabetic nephropathy.