2型糖尿病(T2DM)及糖尿病肾病(diabetic nephropathy,DN).doc

目的
通过比较2型糖尿病(T2DM)及糖尿病肾病(diabetic nephropathy,DN)不同分期患者血清1,25-二羟维生素D3与抵抗素(resistin)的水平,探讨血清1,25-二羟维生素D3与抵抗素的相关性。
方法
选取我院肾内科血肌酐(SCr)水平正常2型糖尿病(T2DM)住院病人60人,空腹血糖(FPG)<7mmol/l,糖化血红蛋白(HbA1c)<%依据尿白蛋白/肌酐(ACR)分为正常白蛋白尿组(DN1)微量白蛋白尿组(DN2)大量白蛋白尿组(DN3)每组20人。选取20例健康查体志愿者作为正常对照组(NC)研究对象均测量身高、体重,计算BMI。使用ELASA血清1,25-二羟维生素D3与抵抗素水平,同时测定空腹血糖、糖化血红蛋白、空腹C肽(C-P)血脂、血浆白蛋白、血清肌酐,计算肾小球滤过率(GFR)并进行相关性分析。
结果
单因素方差分析显示NC、DN1、DN2、DN3四组血清1,25-二羟维生素D3水平较逐渐降低,且组间差异有统计学意义(P<)而血清抵抗素水平逐渐升高,且组间差异有统计学意义(P<)血清1,25(OH)2D3与抵抗素、HbA1c、LDL-C、Scr有明显的负相关性(P均<)而与GFR呈明显的正相关性(P<)多元线性回归分析显示1,25(OH)2D3与抵抗素及GFR存在明显的线型数量关系(P<)
结论
1、T2DN、DN患者存在血清1,25-二羟维生素D3的缺乏及血清抵抗素的升高。2、血清1,25-二羟维生素D3的缺乏与肾脏损害程度相关,可以作为DN患者早期评价肾脏损害的指标。3、T2DN、DN患者存在血清抵抗素的升高与1,25(OH)2D3的缺乏存在相关性。
关键词:糖尿病肾病;尿白蛋白/肌酐;1,25-二羟维生素D3;抵抗素
Abstract
Objective:In order to explore correlation between serum 1,25-Dihydroxyvitamin D3 and resistin paring the standard of serum 1,25-Dihydroxyvitamin D3 and resistin between type 2 diabetes mellitus(T2DM)and diabetic nephropathy(DN)
Methods:A total of 80 type 2 diabetics with the normal serum creatinine(Scr)
Level,FPG<7mmol/l and HbA1c<%were divided into three groups accoding to urinary albumin to creatinine ratio(ACR)normoalbuminuria diabetic group(DN1 n=20)microalbuminuria diabetic group(DN2,n=20)proteinuria group(DN3,n=20)20 cases healthy volenteers were as control goup(NC,n=20)Hight and weight were measured to calculate BMI,serum creatinine(Scr)was measured to calculate Glomerular filtration rate(GFR)and 1,25-Dihydroxyvitamin D3,resistin,glucose,lipid,HbA1c,fasting c-peptide(C-P)lipid and plasma-albumin were measured at the same the relationship between the above parameters and serum l,25-Dihydroxyvitamin D3 level among all these research objects.
Results:Serum 1,25-Dihydroxyvitamin D3 levels were gradually decreased among the four groups of type 2 diabetics and significant differences were observed in parison(P<)while serum resistin levels were significantly increased