尿单核细胞趋化蛋白-1在2型糖尿病早期肾损伤中的意义  

Significance of urinary monocyte chemotactic protein-1 in the determination of early renal injury in the patients with type 2 diabetes mellitus

作　　者：史恒川[1] 刘俊恒[1] 朱建一[1] 

机构地区：[1]江苏省省级机关医院检验科,江苏省南京市210024

出　　处：《实用老年医学》2014年第7期563-565,共3页Practical Geriatrics

摘　　要：目的探讨老年2型糖尿病不同肾病分期患者尿单核细胞趋化蛋白-1(UMCP-1)的变化及其临床意义。方法测定85例老年2型糖尿病肾病患者(2型糖尿病组)和30例健康体检者(对照组)UMCP-1、尿微量白蛋白(UALB)、血清总胆固醇(TC)、血清甘油三酯(TG)、血清低密度脂蛋白胆固醇(LDL-C)、血清高密度脂蛋白胆固醇(HDL-C)以及糖化血红蛋白(HbA1c)水平,同时按UALB水平将2型糖尿病患者分为3组:蛋白尿正常组、微量白蛋白尿组、临床白蛋白尿组,将各组间检测数据进行分析比较。结果老年2型糖尿病组UMCP-1水平明显高于对照组(P<0.01),在糖尿病肾病各分组中,UMCP-1水平比较差异均有统计学意义(P<0.05),UMCP-1水平随着蛋白尿程度的增加而升高(r=0.524,P<0.05),且在蛋白尿正常组患者UMCP-1水平也明显高于对照组。结论 UMCP-1水平升高提示炎症反应在2型糖尿病肾病的发生和发展中起着重要作用,且早于UALB发生变化,可作为早期诊断2型糖尿病肾病的有效指标。Objective To observe the changes of urine monocyte chemotactic protein-1 （UMCP-1） in the elderly patients with type 2 diabetes mellitus with different diabetic nephropathy stages. Methods Eighty-five cases of elderly type 2 diabetic nephropathy patients and 30 healthy controls were enrolled in this study. The levels of UMCP-1, urinary albumin, serum total cholesterol （TC）, triglyceride （TG）, serum low-density lipoprotein cholesterol （LDL-C）, serum high- density lipoprotein cholesterol （HDL-C） and glycosylated hemoglobin （HbAlc） were detected. According to the level of microalbuminuria, the patients with type 2 diabetes mellitus were divided into three groups： normal albuminuria group, mi- croalbuminuria group, the clinical albuminuria group, and the test data were analyzed and compared between the groups. Results The UMCP-1 level in the elderly patients with type 2 diabetes mellitus was significantly higher than that in the control group （P〈0.01）. The UMCP-1 level increased with the increase of the degree of proteinuria in the patients with diabetic nephropathy （r= 0. 524, P〈0. 05）, and the level of UMCP-1 was also significantly increased in the patients with type 2 diabetes mellitus with normal albuminuria. Conclusions The increase of UMCP-1 level suggests that inflammatory response might play an important role in the occurrence and development of diabetic nephropathy in type 2 diabetes mellitus, and the change of UMCP-1 occurs earlier than urine albumin. Therefore, UMCP-1 might be used as a valid indicator for early diagnosis of type 2 diabetic nephropathy.

关 键 词：2型糖尿病 肾病 尿单核细胞趋化蛋白-1 白蛋白尿 

分 类 号：R587.2[医药卫生—内分泌]