2型糖尿病肾病患者内脂素、脂联素和C反应蛋白变化及其临床意义  

Changes and Clinical Significance of Serum Levels of Visfatin,Adiponectin and C-reaction Protein in Type 2 Diabetic Patients with Nephropathy

作　　者：唐灵[1] 陈春莲[1] 苏桂兰[1] 刘树娇[1] 陈虹[1] 

机构地区：[1]桂林医学院附属医院老年内科,广西桂林市541001

出　　处：《中国全科医学》2011年第23期2616-2619,共4页Chinese General Practice

摘　　要：目的检测2型糖尿病肾病患者血清内脂素、脂联素和C反应蛋白（CRP）水平,探讨三者在2型糖尿病肾病发生、发展机制中的作用及临床意义。方法选择97例2型糖尿病患者,根据尿清蛋白排泄率（UAER）分为3组：正常蛋白尿组（UAER〈20μg/m in）35例,微量蛋白尿组（UAER 20~200μg/m in）30例,大量蛋白尿组（UAER〉200μg/m in）32例;另选健康体检正常者35例为对照组。采用酶联免疫吸附法（ELISA）检测受检者内脂素、脂联素水平,免疫比浊法测定CRP。同时测定空腹血糖（FPG）、糖化血红蛋白（HbA1 c）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿素氮（BUN）、血肌酐（SCr）及UAER,比较各组间的差异。结果 3组患者血清内脂素和CRP水平明显高于对照组,差异均有统计学意义（P〈0.05）。正常蛋白尿组血清脂联素低于对照组,微量蛋白尿组、大量蛋白尿组血清脂联素高于对照组,差异有统计学意义（P〈0.01）。内脂素和CRP分别与病程、收缩压（SBP）、HbA1 c、FPG、TG、TC、LDL-C、BUN、SCr、UAER呈正相关（P〈0.01）,与HDL-C呈负相关（P〈0.01）。脂联素与病程、SBP、BUN、SCr、UAER呈正相关（P〈0.01）。结论血清内脂素、脂联素和CRP可能参与了2型糖尿病肾病的发生、发展,联合检测三者水平可能对评估早期糖尿病肾病有意义。Objective To explore the roles of serum visfatin,adiponectin and C-reaction protein（CRP） in the pathogenesis and progress of nephropathy among type 2 diabetic patients through serum levels detection.Methods A total of 97 patients with type 2 diabetes mellitus were divided into three groups according to the urinary albumin excretion rate（UAER）：normalalbuminuria group（UAER20 μg/min,35 cases）,micro-albuminuria group（UAER 20~200 μg/min,30 cases） and macro-albuminuria（UAER200 μg/min,32 cases）;with 35 healthy subjects included as controls.Serum levels of visfatin and adiponectin were measured by enzyme linked immunosorbent assay（ELISA） and CRP levels were measured by immunoturbidimetry.Further,fasting plasma glucose（FPG）,HbA1c,triglyceride（TG）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,blood urea nitrogen（BUN）,and serum creatinine（SCr） levels together with UAER were also determined.Results Serum visfatin and CRP levels in the diabetic patients were significantly higher than those in controls（P〈0.05）.Serum adiponectin levels in the normalalbuminuria group were lower than those in controls,while in the micro-albuminuria group and the macro-albuminuria group were higher than controls（P〈0.01）.Serum levels of visfatin and CRP were positively correlated with disease course,systolic blood pressure（SBP）,HbA1c,FPG,TG,TC,LDL-C,BUN,SCr and UAER with significance（P〈0.01） while negatively correlated with HDL-C（P〈0.01）.Levels of adiponectin were positively correlated with disease course,SBP,BUN,SCr and UAER（P〈0.01）.Conclusion Serum visfatin,adiponectin and CRP may play important roles in the pathogenesis and development of DN and combinated detection might be useful to be applied in evaluation of early DN.

关 键 词：糖尿病 2型 糖尿病肾病 脂联素 C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]