胰岛素样生长因子及其结合蛋白与2型糖尿病肾脏病变相关性研究  

IGF and IGFBP and their relationship with nephropathy in type-2 diabetes mellitus

作　　者：邝建[1] 杨华章[1] 董晖[1] 裴剑浩[1] 崔炎棠[1] 

机构地区：[1]广东省人民医院内分泌科,广东广州510080

出　　处：《中国实用内科杂志：临床前沿版》2006年第3期433-436,共4页

基　　金：广东省医学科学研究基金资助项目(A1999026)

摘　　要：目的探讨胰岛素样生长因子(IGF)及其结合蛋白(IGFBP)在2型糖尿病肾脏病变中的变化及其相关关系。方法2000-02～2003-05对广东省人民医院的130例(男52例、女78例),年龄在37～75岁2型糖尿病患者,观察了IGFs、IGFBPs、血脂、空腹和餐后2hC肽(CP0、CP120)等与血、尿α1和β2-微球蛋白(MG)的相关性,比较不同肾脏病变组间的IGFs和IGFBPs改变。结果多元逐步回归分析,血α1-MG主要相关预测因子为IGF-2、TC、年龄(r=0.492,P=0.0001);尿α1-MG为IGF-2、年龄(r=0.307,P=0.007);血β2-MG为IGFBP-1、HDL、年龄(r=0.528,P=0.0001);尿β2-MG为IGFBP-1、CP120、年龄(r=0.407,P=0.0001);血肌酐(Cr)为IGFBP-1、CP0、年龄(r=0.499,P=0.0001)。IGF-2和IGFBP-1在糖尿病肾病组显著升高[IGF-2:(889.48±65.94)μg/L对(711.57±28.73)μg/L,P=0.03;IGFBP-1:(94.91±17.48)μg/L对(54.81±5.04)μg/L,P=0.009]。结论2型糖尿病患者血清IGFBP-1、IGF-2水平与血、尿微球蛋白水平有密切的相关性,糖尿病肾病的IGFBP-1和IGF-2明显升高。糖尿病的胰岛功能改变、IGF与IGFBP系统以及脂代谢异常,与糖尿病肾病的发生、发展有关。Objective The aim of the present study was to assess the changes of IGF - 1, IGF - 2, IGFBP - 1 and IGFBP -3 in diabetes nephropathy, the relationships between IGFs, IGFBPs and cq - , ~2 - microglobulin. Methods A total of 130 type -2 diabetic participants （male： 52, female： 78） aged 37 -75 yeares in Guangdong Provincial People＇s Hospital were enrolled from Feb. 2000 to May 2003. Serum IGF - 1, IGF - 2, IGF binding protein 1 （ IGFBP-1）, IGFBP-3, creatinine （Cr）, cholesterol, triglycerides, HDL, LDL, apolipoprotein B100 （apoB100）, apoA, HbAlc, fasting and postprandial C -peptide, serum and urine α1-MG and β2 -MG were measured. Patients were divided into clinical albuminuria （DN, n = 24）, microalbuminuria （MA, n = 40）, and normal （NOR, n = 66） groups according sCr and urine Alb/Cr ratio. Results In multiple linear regression analysis, determinants of S α1 - MG were IGF-2 , TC and age （r=0.492, P=0.0001）; U α1 -MG were IGF-2, age （r=0.307, P=0.007）; S β2-MGwereIGFBP-1, HDLandage （r=0.528, P=0.0001）; U β2-MGwere IGFBP-1, CP120 and age （r=0.407, P=0.0001）; s-Cr were IGFBP- 1, CP0 and age （r=0.499, P=0.0001）. Serum IGF-2 and IGFBP - 1 were significantly increased in DN group [ IGF - 2 ： （889.48 ± 65.94） μg/L vs （711.57 ± 28.73 ） μg/L, P=0. 03; IGFBP-1： （94.91±17.48） μg/Lvs （54.81±5.04） μg/L, P=0. 009]. Conclusion Serum IGFBP - 1 and IGF -2 are significantly increased in type 2 diabetes with nephropathy. The disorders of IGFs and lipid metabolism may contribute to the development of diabetic nephropathy.

关 键 词：2型糖尿病 糖尿病肾病 胰岛素样生长因子 胰岛素样生长因子结合蛋白 

分 类 号：R5[医药卫生—内科学]