2型糖尿病合并慢性肾脏疾病患者血浆Ghrelin水平的变化及其临床意义  

Changes in the level of serum ghrelin in type 2 diabetic patients with chronic kidney disease and its clinical significance

作　　者：李健[1] 刘泽炜[2] 王怀国[2] 张光珍[1] 

机构地区：[1]聊城市人民医院内分泌科,252000 [2]聊城市人民医院肾内科,252000

出　　处：《中国糖尿病杂志》2014年第4期337-339,共3页Chinese Journal of Diabetes

摘　　要：目的探讨血浆Ghrelin在T2DM合并糖尿病慢性肾脏疾病(CKD)发生发展中的作用。方法根据24hUAER,将105例T2DM患者分为正常白蛋白尿组(NA)39例、微量白蛋白尿组(MA)36例及临床白蛋白尿组(CP)30例。另选健康对照者35名为对照(NC)组。测定研究对象血浆Ghrelin、血糖、血脂、UAER、血BUN及Scr水平,比较各组间差异。结果 NA组血浆Ghrelin较NC组下降(P<0.05),MA组及CP组血浆Ghrelin均高于NA组(P<0.05或P<0.01),CP组血浆Ghrelin高于MA组(P<0.05)。相关分析显示,血浆Ghrelin与BMI、HbA1c及FPG呈负相关(r=-0.420、-0.458、-0.433,P<0.05);与UAER、Scr及ISI呈正相关(r=0.322、0.601、0.477,P<0.05)。多元线性回归分析显示,BMI、UAER及HbA1c是T2DM患者Ghrelin独立相关因素。结论血浆Ghrelin随尿白蛋白严重程度而逐渐升高,可能与CKD发生发展密切相关。Objective To explore the role of serum ghrelin in the pathogenesis and progress of chronic kidney disease in T2DM.Methods A total of 105 patients with T2DM were divided into normal albuminuria group （NA group,n =39）,micro-albuminuria group （MA group,n =36）,and macroalbuminuria group（CP group,n=30） according to the urinary albumin excretion rate（UAER）.Another healthy subjects （n=35） were included as control （NC） group.Serum level of ghrelin was measured by enzyme linked immunosorbent assay （ELISA）.Levels of fasting plasma glucose （FPG）,HbA1c,triglyceride,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）,blood urea nitrogen（BUN）,serum creatinine（Scr） and UAER were determined.Results Levels of serum ghrelin were lower in NA group than in NC group（P〈0.05）and higher in both MA and CP group than in NA group（P〈0.05 or P〈0.01）.Levels of ghrelin were positively correlated with UAER、Scr、ISI,while negatively correlated with BMI、HbA1c、FPG.Multiple linear regression analysis showed that BMI、UAER、HbA1c were independent factors to the plasma levels of ghrelin in the NA、MA and CP groups.Conclusion Ghrelin may play an important roles in the occurrence of the CKD in T2DM.

关 键 词：糖尿病 2型 糖尿病慢性肾脏疾病 尿白蛋白排泄率 GHRELIN 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]