2型糖尿病肾病患者血清visfatin、Apelin的变化及其临床意义  

Changes of the serum levels of visfatin and Apelin in type 2 diabetic patients with nephropathy

作　　者：李健[1] 王怀国[2] 刘泽玮 张光珍[1] 

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

出　　处：《中华临床医师杂志（电子版）》2014年第17期30-34,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的检测2型糖尿病肾病患者血清visfatin、Apelin水平,探讨其在2型糖尿病肾病发生发展中的作用及临床意义。方法根据24 h尿微量白蛋白排泄率(UAER)将105例2型糖尿病患者分为正常白蛋白尿组(NA组,39例)、微量白蛋白尿组(MA组,36例)、临床白蛋白尿组(CP组,30例),选取健康者作为对照组(NC组,35例)。采用酶联免疫吸附法(ELISA)测定血清visfatin、Apelin水平,同时测定患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂、血尿素氮、血肌酐(Scr)、BMI,计算UAER,比较各组间的差异。结果与NC组比较,3组糖尿病患者血清visfatin、Apelin水平显著升高(P<0.01),3组糖尿病患者之间血清visfatin、Apelin逐渐升高(P<0.05或P<0.01)。相关分析显示,visfatin与BMI、FPG、HbA1c、HOMA-IR、TG、LDL-C、Scr、UAER、Apelin呈正相关(P<0.05);Apelin与BMI、收缩压、FPG、HbA1c、HOMA-IR、LDL-C、Scr、UAER、visfatin呈正相关(P<0.05);visfatin、Apelin均与HDL-C呈负相关(P<0.05)。多元线性回归分析显示:Scr、UAER是糖尿病组患者血清visfatin的独立相关因素(r2分别为0.325、0.267,P<0.05)。HOMA-IR、UAER是糖尿病组患者血清Apelin的独立相关因素(r2分别为0.256、0.487,P<0.05)。结论血清visfatin、Apelin随UAER升高而逐渐升高,其可能参与了糖尿病肾病的发生和发展。Objective To explore the role of serum visfatin and Apelin in the pathogenesis and progress of nephropathy among type 2 diabetic patients. Methods A total of 105 patients with type 2 diabetes mellitus were divided into three groups according to the urinary albumin excretion rate（UAER）： normal albuminuria group（NA group） 39 cases, micro-albuminuria group（MA group） 36 cases, and macro-albuminuria group（CP group） 30 cases; with 35 cases healthy subjects included as controls. Serum levels of visfatin and Apelin were assayed by enzyme linked immunosorbent assay（ELISA）, 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）, and serum creatinine（Scr） levels together with UAER were also determined.Results Serum visfatin and Apelin levels in the diabetic patients were significantly higher than those in controls（P〈0.01）. Levels of visfatin were positively correlated with BMI, FPG, HbA1c, HOMA-IR, TG, LDL-C, Scr, UAER and Apelin, while negatively correlated with HDL-C.Multiple linear regression analysis showed that Scr, UAER were independent related factors to the serum visfatn.Levels of Apelin were positively correlated with BMI, systolic blood pressure, FPG, HbA1c, HOMA-IR, LDL-C, Scr, UAER, visfatin, while negatively correlated with HDL-C. Multiple linear regression analysis showed that HOMA-IR, UAER were independent related factors to the serum Apelin.Conclusion Visfatin and Apelin may contribute, in part, to the pathogenesis of the diabetic nephropathy.

关 键 词：糖尿病肾病 尿微量白蛋白排泄率 VISFATIN APELIN 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]