2型糖尿病患者尿液Smad1改变与糖尿病肾病关系的研究  

Relationship between urinary Smad1 and diabetic nephropathy in T2DM patients

作　　者：付文金[1] 王少波[2] 邓任堂[1] 陈楚填[1] 黄晓芸[1] 陈梅莲[1] 彭兰芬[1] 叶长钦[1] 郑磊[3] 汤惠华[1] 刘亮[1] 陈载鑫[1] 熊石龙[3] 包杰[3] 王前[3] 

机构地区：[1]广东医学院附属厚街医院检验科,东莞523945 [2]广东医学院附属厚街医院内分泌科,东莞523945 [3]南方医科大学南方医院检验科

出　　处：《中国糖尿病杂志》2013年第2期126-128,共3页Chinese Journal of Diabetes

基　　金：东莞市科技局重点课题项目(201205102013)

摘　　要：目的探讨T2DM患者尿液Smad1的表达及其与肾脏损伤的关系。方法选择T2DM患者(T2DM组)118例及正常对照(NC)组28名,按照尿白蛋白/肌酐比值(UACR)分为正常蛋白尿组64例,微量白蛋白尿组36例及大量白蛋白尿组18例。应用ELISA法测定各组尿液Smad1的含量,常规方法测定Cr、胱抑素C(CysC)、FPG、HbA1c、C-P等临床指标,以Macisaac公式估算肾小球滤过率(GFR),分析尿Smad1含量与常用临床指标的相关。结果 T2DM组尿Smad1含量高于NC组,与UACR呈正相关(R=0.412,P=0.000),正常蛋白尿组、微量蛋白尿组、大量蛋白尿组尿Smad1含量呈递增改变;相关分析显示Smad1与FPG、HbA1c呈正相关,与FC-P肽呈负相关;Logistic回归分析表明尿液Smad1是T2DM患者肾功能损伤的独立危险因素。结论尿液Smad1可反映DN损伤程度并与DN分期相关;尿液Smad1的检测对DN患者病情观察、疗效判断具有一定的临床价值。Objective To explore the relationship between urinary smad1 and diabetes nephropathy in T2DM patients.Methods The 118 T2DM patients and 28 control subjects were enrolled in the trial.The patients were divided into 3 groups according to urine albumin/creatinine ratio（UACR）,64 in normal albuminuria group,36 in microalbuminuria group,and 18 in macroalbuminuria group.Their urinary smad1 was measured by ELISA.FPG,creatinine（Cr）,serum cystatin C（CysC）,HbA1c,and C-P were also examined.Glomerular filtration rate（GFR） was determined by Macisaac formulae to analyze the relations between urinary smad1 and the common clinical indices.Results The level of urinary smad1 was significantly higher in the T2DM patients than in the controls and positively related with UACR in T2DM（R=0.412,P=0.000）,and was getting progressively higher in the normal albuminuria group,microalbuminuria group,and macroalbuminuria group.Pearson analysis showed that the level of urinary smad1 was positively related with FPG and HbA1c,but negatively with fasting C-P.Logistic regrsssion analysis showed that the urinary smad1 was an independent risk factor for diabetic nephropathy in T2DM patients.Conclusion Urinary smad1 is related with the degree of diabetic nephropathy,and may be a promising marker for the diagnosis and monitoring the treatment of DN.

关 键 词：糖尿病 2型 糖尿病性肾脏疾病 SMAD1 尿白蛋白 肌酐比值(UACR) 

分 类 号：R587.1[医药卫生—内分泌] R692.9[医药卫生—内科学]