2型糖尿病患者不同尿白蛋白排泄率尿MCP-1的变化及临床意义

目的观察2型糖尿病(DM2)患者不同尿白蛋白排泄率尿单核细胞趋化蛋白-1(MCP-1)含量变化及临床意义。方法59例糖尿病患者根据尿蛋白排泄量(UAE)分成3组,分别测定其尿MCP-1的水平及血肌酐(SCr)、尿素氮(BUN)、血脂、血压、糖化血红蛋白(HbA1c),并与27例年龄、性别、体质指数(BMI)与观察组相匹配的对照组相比较。结果2型DM患者尿MCP-1水平明显高于对照组,在正常蛋白尿组中尿MCP-1就已经开始升高(P<0.05),微量蛋白尿组及临床蛋白尿组尿MCP-1水平明显高于正常蛋白尿组,且临床蛋白尿组尿MCP-1水平显著高于微量蛋白尿组;2型DM患者尿MCP-1水平与UAE、收缩压、舒张压、LDL-C、CHO呈显著正相关(P<0.05),而与HbA1c、HDL-C、TG无统计学相关性。结论MCP-1可能参与了糖尿病肾病(diabetic nephropathy,DN)的发生发展,检测尿中MCP-1含量对于早期DN的诊断及其干预有重要意义。

Clinical Significance and Levels of Urinary Monocyte Chemoattractant Protein-1 in Type 2 Diabetes Mellitus

Objective To investigate the levels and the clinical significance of urinary monocyte chemoattractant protein-1(uMCP-1)at different stage of diabetic nephropathy(DN).Methods Fifty-nine cases with diabetes mellitus(DM)were divided into three groups according to urine albumin excretion(UAE):normal albuminuria group;microalbuminuria group and clinical albuminuria group.The levels of uMCP-1,SCr,BUN,serum lipid concentration,blood pressure and HbA1c were measured,and twenty-seven normal control subjects were measured at the same time.Results Compared with normal control,levels of uMCP-1 in DM were significantly high.Compared with normal albuminuria group,levels of uMCP-1 in microalbuminuria group and clinical albuminuria group were significantly high.Level of uMCP-1 in clinical albuminuria group was higher than that of microalbuminuria group.Level of uMCP-1 was positively correlated with UAE,systolic blood pressure(SBP),diastolic blood pressure(DBP),CHO and LDL-C in DM patients,while had no significant correlation with HbA1c,TG and HDL-C.Conclusion MCP-1 is implicated in the development and progression of DN.Measuring level of uMCP-1 is very important in the diagnosis and intervention of early DN.