血清脂联素、抵抗素在2型糖尿病肾病中的水平分析

[目的]探讨血清脂联素、抵抗素在2型糖尿病肾病(DN)发生、发展中的作用。[方法]选择糖尿病患者90例,根据尿微量白蛋白排泄率(UAER)分为单纯糖尿病组30例、早期DN组30例、临床DN组30例,同时取正常人30例为对照组。测定所有研究对象的血清脂联素、抵抗素水平,并分析其与UAER等指标的关系。[结果](1)正常人血清脂联素明显高于2型糖尿病患者(P﹤0.01),糖尿病患者中早期DN组的血清脂联素高于单纯糖尿病组(P﹤0.05),临床DN组的血清脂联素水平最高(P﹤0.01)。血清抵抗素水平在单纯糖尿病组、早期DN组及临床DN组中均明显高于健康对照组(P﹤0.05或P﹤0.01),且随病情进展逐渐升高。(2)在DN阶段,血清脂联素与抵抗素水平呈显著正相关,相关系数r=0.449(P﹤0.01);血清脂联素、抵抗素水平分别与UAER、血糖(BG)、血肌酐(Scr)、糖化血红蛋白(HbA1c)水平相关。(3)对糖尿病患者逐步回归分析显示,血清脂联素、抵抗素受UAER、HbA1c及Scr的影响较大。[结论脂联素、抵抗素与糖尿病肾病,发生、发展有关,检测其血清水平可能对早期诊断和评估DN有作用。脂联素、抵抗素有望成为治疗DN的新靶点。

ANALYSIS OF SERUM ADIPONECTIN AND RESISTIN IN THE TYPE 2 DIABETIC NEPHROPATHY

[Objective]To investigate the effect of adiponectin and resistin on the production and progress in the type 2 diabetic nephropathy(DN).[Methods]90 cases of type 2 diabetic mellitus patients were enrolled in this study,according to the level of urinary albumin excretion(UAER),all the patients were divided into 3 groups:There were 30 cases with simple diabetes mellitus(SDM),30 cases with early diabetic nephropathy(EDN)and 30 cases with clinical diabetic nephropathy(CDN).The 30 cases of healthy persons were as normal controls.The levels of serum adiponectin and resistin of all the patients and normal control persons were measured.The relationship between adiponectin,resistin,UAER and other parameters were analyzed.[Results](1)The levels of serum adiponectin were higher in normal healthy people than in type 2 diabetic patients(P﹤0.01),and were higher in EDN group than in SDM group(P﹤0.05)and the serum adiponectin concentrations were significantly highest in the CDN group than in SDM and EDN groups(P﹤0.01).Levels of serum resistin in type 2 diabetic group were significantly higher than those in control group(P﹤0.05 or P﹤0.01).The serum levels of resistin were significantly higher with the development of illness in DN patients.(2)At the stage of the DN,the levels of the serum of adiponectin and resistin were positively correlated,the correlation coefficient was r = 0.449(P﹤0.01).The levels of the serum of adiponectin and resistin,the levels of UAER,BG,Scr and HbA1c were also correlated.(3)Stepwise regression analyses showed that UAER,HbAlc and Scr highly influenced serum adiponectin and resistin.[Conclusion]Adiponectin and resistin may play important roles in the occurrence of the diabetic mellitus nephropathy.Levels of serum adiponectin and resistin may have affect on early diagnosis and estimation of the DN.Adiponectin and resistin may be as the new treatment targets of the DN.