尿单核细胞趋化蛋白-1在2型糖尿病早期肾损伤中的意义

目的探讨老年2型糖尿病不同肾病分期患者尿单核细胞趋化蛋白-1（UMCP-1）的变化及其临床意义。方法测定85例老年2型糖尿病肾病患者（2型糖尿病组）和30例健康体检者（对照组）UMCP-1、尿微量白蛋白（UALB）、血清总胆固醇（TC）、血清甘油三酯（TG）、血清低密度脂蛋白胆固醇（LDL-C）、血清高密度脂蛋白胆固醇（HDL-C）以及糖化血红蛋白（HbA1c）水平，同时按UALB水平将2型糖尿病患者分为3组：蛋白尿正常组、微量白蛋白尿组、临床白蛋白尿组，将各组间检测数据进行分析比较。结果老年2型糖尿病组UMCP．1水平明显高于对照组（P〈0．01），在糖尿病肾病各分组中，UMCP-1水平比较差异均有统计学意义（P〈0．05），UMCP．1水平随着蛋白尿程度的增加而升高（r=0．524，P〈0．05），且在蛋白尿正常组患者UMCP-1水平也明显高于对照组。结论UMCP-1水平升高提示炎症反应在2型糖尿病肾病的发生和发展中起着重要作用，且早于UALB发生变化，可作为早期诊断2型糖尿病肾病的有效指标。

Significance of urinary monocyte chemotactic protein-l in the determination of early renal injury in the patients with type 2 diabetes mellitus

Objective To observe the changes of urine monocyte chemotactic protein-1 （UMCP-1） in the elderly patients with type 2 diabetes mellitus with different diabetic nephropathy stages. Methods Eighty-five cases of elderly type 2 diabetic nephropathy patients and 30 healthy controls were enrolled in this study. The levels of UMCP-1, urinary albumin, serum total cholesterol （TC）, triglyceride （TG）, serum low-density lipoprotein cholesterol （LDL-C）, serum high- density lipoprotein cholesterol （HDL-C） and glycosylated hemoglobin （HbAlc） were detected. According to the level of microalbuminuria, the patients with type 2 diabetes mellitus were divided into three groups： normal albuminuria group, mi- croalbuminuria group, the clinical albuminuria group, and the test data were analyzed and compared between the groups. Results The UMCP-1 level in the elderly patients with type 2 diabetes mellitus was significantly higher than that in the control group （P〈0.01）. The UMCP-1 level increased with the increase of the degree of proteinuria in the patients with diabetic nephropathy （r= 0. 524, P〈0. 05）, and the level of UMCP-1 was also significantly increased in the patients with type 2 diabetes mellitus with normal albuminuria. Conclusions The increase of UMCP-1 level suggests that inflammatory response might play an important role in the occurrence and development of diabetic nephropathy in type 2 diabetes mellitus, and the change of UMCP-1 occurs earlier than urine albumin. Therefore, UMCP-1 might be used as a valid indicator for early diagnosis of type 2 diabetic nephropathy.