对氧磷酯酶1与2型糖尿病肾病的关系  

The relationship between serum paraoxonase-1activity and diabetic nephropathy in patients with type 2 diabetes mellitus

作　　者：曾昭淳[1] 刘万里[1] 王红漫[2] 张革[1] 柯细松[1] 曾繁荣[3] 

机构地区：[1]重庆医科大学基础医学院生物化学教研室,400016 [2]重庆医科大学第一医院内分泌科 [3]重庆医科大学第一医院老年科

出　　处：《中华内分泌代谢杂志》2002年第2期124-126,共3页Chinese Journal of Endocrinology and Metabolism

基　　金：重庆市卫生局医学研究基金资助 (99 2 0 2 6)

摘　　要：目的　探讨血清对氧磷酯酶 1(PON1)活性与 2型糖尿病 (DM)并发肾病 (DN)的关系。方法　血清PON1活性用酚乙酸酯为底物测定 ,血浆氧化型低密度脂蛋白 (ox LDL)用ELISA法测定 ,尿 2 4小时微量白蛋白用放免法测定。结果　 91例 2型DM患者的PON1活性比 5 4例正常对照显著降低〔(138.2± 31.4 )kU/Lvs (184 .1± 2 9.5 )kU/L ,P <0 .0 0 1〕 ,且 2型DM的Ⅰ组 (UAER <30mg/ 2 4h)、Ⅱ组 (UAER 30～ 30 0mg/ 2 4h)和Ⅲ组 (UAER >30 0mg/ 2 4h)相比 ,PON1活性依次显著下降〔(15 1.8± 2 4 .5 )kU/L ,(12 4 .5± 32 .8)kU/L ,(10 1.1± 36 .6 )kU/L ,P <0 .0 1〕 ,而ox LDL的浓度却依次显著升高〔(6 16 .2± 135 .7) μg/L ,(75 3.9± 132 .5 ) μg/L ,(875 .1± 15 3.2 ) μg/L ,P <0 .0 1〕。PON1活性与ox LDL的浓度呈高度负相关 (r =- 0 .83,P <0 .0 0 1) ,也与UAER呈负相关 (r =- 0 .2 8,P<0 .0 5 ) ,多元回归分析表明PON1活性是 2型DM并发DN的高度危险因素 (P <0 .0 1)。结论　PON1活性在 2型DM显著下降 ,且在并发DN的 2型DM患者下降更显著。PON1活性与ox LDL呈负相关。PON1活性降低是Objective To investigate the relationship between serum paraoxonase 1 (PON1) activity and diabetic nephropathy (DN) in the patients with type 2 diabetes mellitus (DM). Methods Serum PON1 activity was assayed using phenyl acetate as a substrate; plasma oxidized low density lipoprotein (ox LDL) was determined by ELISA; urinary albumin excretion rate (UAER) was measured by radioimmunoassay. Results Serum PON1 activity in 91 patients with type 2 DM was significantly lower than that in 54 controls 〔 (138.2±31.4)kU/L vs (184.1±29.5)kU/L,P<0.001〕. Among type 2 DM patients, divided by UAER〔 group Ⅰ (UAER<30 mg/24h), group Ⅱ (UAER 30～300 mg/24h) and group Ⅲ (UAER>300 mg/24h)〕, serumPON1activitiesweredecreased〔 (151.8±24.5)kU/L,(124.5±32.8)kU/L, (101.1±36.6)kU/L, respectively, P<0.01〕,andplasmaox LDLlevelswere increased 〔(616.2±135.7)μg/L, (753.9±132.5)μg/L, (875.1±153.2)μg/L, respectively, P<0.01〕. There was significantly negativecorrelationbetweenserumPON1activitiesandlevelsofox LDL (r=-0.83,P<0.001) and so was between serum PON1 activities and UAER (r=-0.28,P<0.05).Conclusion Serum PON1 activity is significantly decreased in type 2 DM patients especially in type 2 DM patients with nephropathy. Negative correlation exists between serum PON1 activity and plasma ox LDL level. The lower serum PON1 activity is a highly independent risk factor of type 2 DM patients complicated with nephropathy.

关 键 词：非胰岛素依赖型糖尿病 糖尿病肾病 对氧磷酯酶1 氧化型低密度脂蛋白 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]