尿脂联素与糖尿病肾病严重程度的相关性研究

目的 探讨尿脂联素与糖尿病肾病严重程度的相关性.方法 150例糖尿病患者根据尿微量白蛋白/肌酐(ACR)分为正常白蛋白尿组(ACR＜ 30 mg/g),微量白蛋白尿组(ACR30～300 mg/g),大量白蛋白尿组(ACR＞ 300 mg/g),每组均为50例.同时选取健康体检者30名作为对照组.应用全自动生化分析仪测定空腹血糖、HbA1c、肌酐、白蛋白、甘油三酯、总胆固醇、高密度脂蛋白-胆固醇(HDL-C)、低密度脂蛋白-胆固醇(LDH-C)等生化指标.采用酶联免疫吸附法测定血、尿脂联素水平.结果 血、尿脂联素及HbA1c水平在对照组、正常白蛋白尿组、微量白蛋白尿组及大量白蛋白尿组中依次升高,差异均有统计学意义(F=62.46,65.26,5.37,P均＜0.05);血肌酐水平随尿白蛋白水平升高依次升高,微量白蛋白尿组及大量白蛋白尿组与对照组之间比较,差异有统计学意义(F=8.25,P＜0.05),微量白蛋白尿组及大量白蛋白尿组与正常白蛋白尿组之间比较无明显统计学意义(P＞0.05);估算的肾小球滤过率(eGFR)随尿白蛋白水平升高依次降低(F=54.67,P＜0.01).Pearson相关分析显示尿脂联素与血肌酐、ACR、血脂联素、HbA1c呈正相关(r=0.66,0.61,0.62,0.35,P均＜0.05),与eGFR呈负相关(r=-0.71,P＜0.01).多元逐步回归分析发现尿脂联素与血肌酐、HbA1c、ACR、eGFR及血脂联素相关(P均＜0.05).结论 尿脂联素与糖尿病肾病的严重程度呈正相关.

Relationship between urinary adiponectin and the severity of diabetic nephropathy

Objective To explore the relationship between urinary adiponectin and the severity of diabetic nephropathy.Methods A total of 150 patients with type 2 diabetes mellitus were divided into three groups based on urinary albumin/creatinine (ACR):normal albuminuria group (ACR ＜ 30 mg/g),microalbuminuria group(ACR 30-300 mg/g),macroalbuminuria group(ACR ＞ 300 mg/g),with 50 cases in each group.Meanwhile,30 healthy people were chosen as control group.Fasting blood glucose (FBG),HbA1c,serum creatinine,albumin,triglycerides,total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured by automatic biochemical analyzer.Plasma and urinary adiponectin concentrations were measured by enzyme linked immuno-sorbent assay.Results The levels of serum and urinary adiponectin,as well as HbA1c were increased gradually in control group,normal albuminuria group,microalbuminuria group and macroalbuminuria group,and the differences were statistically significant between groups (F =62.46,65.26,5.37,all P ＜ 0.05).Serum creatinine increased with the increase of urinary protein,and the difference were statistically significant between microalbuminuria group,macroalbuminuria group and control group (F =8.25,P ＜ 0.05);no difference was found between microalbuminuria group,macroalbuminuria group and normal albuminuria group (P ＞0.05).With the decrease of proteinuria,estimated glomerular filtration rate (eGFR) increased (F =54.67,P ＜ 0.01).Pearson correlation analysis showed that urinary adiponectin was positively correlated with serum creatinine,ACR,serum adiponectin,and HbA1c (r=0.66,0.61,0.62,0.35,all P ＜ 0.05),and was negatively correlated with eGFR (r =-0.71,P ＜ 0.01).Multiple stepwise regression analysis showed that urinary adiponectin was associated with serum creatinine,HbA1c,ACR,eGFR and serum adiponectin (all P ＜ 0.05).Conclusion Urinary adiponectin level is positively correlated with the severity of diabetic nephropathy.