血清及尿中微量元素铬的水平与2型糖尿病肾病的相关性分析  

Study on the correlation between the levels of serum and urine trace element of chromium with type 2 diabetic nephropathy

作　　者：刘俊峰[1] 鞠萍[1] 黄娟[1] 

机构地区：[1]黄石市第二医院检验科,湖北黄石435002

出　　处：《检验医学》2014年第10期1023-1027,共5页Laboratory Medicine

基　　金：黄石市科技局资助项目(黄科发农2009[1])

摘　　要：目的探讨血清微量元素铬(Cr)的水平与糖尿病肾病(DN)的相关性。方法采用磁性纳米材料(Fe3O4@ZrO2)磁固相萃取-火焰原子吸收光谱法测定30例2型糖尿病(T2DM)患者(T2DM组)、30例DN患者(DN组)及30名健康体检者(正常对照组)血清、尿液三价铬离子(Cr3+)及六价铬离子(Cr6+)水平。采用放射免疫法检测血清胰岛素(INS)和C肽,同时检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、肌酐(SCr)、尿素氮(BUN)、半胱氨酸蛋白酶抑制剂C(Cys C)、微量白蛋白(mAlb)等生化指标。采用简化肾脏病膳食改善(MDRD)公式计算肾小球滤过率(eGFR)。结果 DN组血清Cr3+明显低于T2DM组和正常对照组(P<0.01),而尿Cr3+明显高于T2DM组和正常对照组(P<0.01);DN组血清Cr6+明显高于正常对照组(P<0.01),但与T2DM组比较差异无统计学意义(P>0.05);T2DM组血清Cr3+水平明显低于正常对照组(P<0.01),而尿Cr3+和血清Cr6+水平高于正常对照组(P<0.01)。T2DM组和DN组血清Cr3+与eGFR呈正相关(r=0.088,P<0.05;r=0.146,P<0.01),与HbA1c、FBG、Cys C、SCr、mAlb呈负相关(T2DM组:r值分别为-0.098、-0.103、-0.154、-0.127、-0.355,P均<0.05;DN组:r值分别为-0.106、-0.107、-0.195、-0.150、-0.447,P均<0.05),与TC、TG、BUN不相关(T2DM组:r值分别为0.010、0.011、0.044,P均>0.05;DN组:r值分别为0.010、0.010、0.049,P均>0.05)。结论 DN患者血清铬存在不同程度的降低,尿铬离子升高。微量元素铬的水平与T2DM患者肾功能损伤的发生有一定关系。Objective To investigate the levels of serum and urine trace element of chromium (Cr)and its correlation with diabetic nephropathy (DN).Methods The study enrolled 30 patients with type 2 diabetes mellitus (T2DM)(T2DMgroup),30 patients with DN (DN group)and 30 healthy subjects (healthy control group).Serum and urine Cr3 + and Cr6 + levels were determined by magnetic nanoparticle (Fe3 O4 @ ZrO2 )combining magnetic solid-phase extraction-flame atomic absorption spectrometry. Serum insulin (INS ) and C peptide were detected by radioimmunoassay method.Serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),glycosylated hemoglobin A1 c (HbA1 c ), creatinine(SCr),urea nitrogen(BUN),cystatin C(Cys C)and microalbumin (mAlb)were detected.The estimated glomerular filtration rate (eGFR)was calculated by modification of diet in renal disease (MDRD).Results The level of serum Cr3 + in DN group was significantly lower than those in T2DMand healthy control group(P <0.01 ).However, urine Cr3 + level was significantly higher than those in T2DMand healthy control group(P <0.01 ).The level of serum Cr6 + in DN group was significantly higher than that in healthy control group (P <0.01 ),and there was no statistical significance with that in T2DM group (P >0.05).In T2DM group,serum Cr3 + level was lower than that in healthy control group (P <0.01 ),and urine Cr3 + and serum Cr6 + levels were higher than those in healthy control group (P <0.01 ).Between DN and T2DM groups,the level of serum Cr3 + had positive correlation with eGFR(r =0.088,P <0.05;r =0.1 46,P <0.01 ),and there were negative correlations with HbA1 c ,FBG,Cys C,SCr and mAlb(T2DM group:r =-0.098,-0.1 03,-0.1 54,-0.1 27 and -0.355,P <0.05;DN group:r =-0.1 06, -0.1 07,-0.1 95,-0.1 50 and -0.447,P <0.05).There was no correlation with TC,TG and BUN(T2DM group:r =0.01 0,0.01 1 and 0.044,P >0.05;DN group:r =0.01 0,0.01 0 and 0.049,P >0.05).Conclusions The level of serum Cr in

关 键 词：铬 微量元素 糖尿病肾病 相关性 

分 类 号：Q581[生物学—生物化学]