糖尿病肾病与血糖波动和炎性因子的关系探讨  

Relation of diabetic nephropathy and blood glucose fluctuation with inflammatory factors

作　　者：苏弘薇 康省 龙艳[2] 夏宁[1] 

机构地区：[1]广西医科大学,530021 [2]桂林医学院附属医院内分泌科

出　　处：《中华老年心脑血管病杂志》2015年第3期273-276,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：广西自然科学基金(2012GXNSFAA053085);广西教育厅科研课题(201204LX245)

摘　　要：目的探讨糖尿病肾病与血糖波动和炎性因子的关系。方法选择2型糖尿病患者109例,动态血糖监测72h,根据尿白蛋白排泄率(UAER)分为大量白蛋白尿组(A组)36例、微量白蛋白尿组(B组)35例和正常白蛋白尿组(C组)38例。另选健康体检者30例为对照组(D组)。糖尿病患者常规治疗12周,测治疗前后空腹血糖(FPG)、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)、平均血糖波动幅度(MAGE)、白细胞介素6(IL-6)、TNF-α和UAER。结果 A组、B组和C组治疗后FPG、TG、HbA1c较治疗前明显下降(P<0.05);A组和B组IL-6、TNF-α、MAGE、UAER较治疗前明显下降(P<0.05,P<0.01),MAGE与UAER(r=0.392,P=0.013)、IL-6(r=0.587,P=0.002)、TNF-α(r=0.659,P=0.000)呈正相关;年龄、病程、收缩压、HbA1c、IL-6、TNF-α、MAGE是导致患者UAER的危险因素。结论血糖波动与炎性因子密切相关,炎性因子参与糖尿病肾病的发生和发展。Objective To study the relation of diabetic nephropathy and blood glucose fluctuation with inflammatory factors .Methods One hundred and nine T2DM patients with their 72 h blood glucose dynamically monitored were divided into macroalbuminuria group （group A ,n=36） ,mi‐croalbuminuria group （group B ,n=35） and normal albuminuria group （group C ,n=38） according to their urinary albumin excretion rate （UAER） .Thirty subjects undergoing physical examination served as a control group .The patients were treated with insulin for 12 weeks .Their FPG ,FINS , HbA1c ,MAGE ,IL‐6 ,TNF‐α ,and UAER were measured before and after treatment .Results The serum levels of FPG ,TG ,HbA1c were significantly lower in groups A ,B and C after treatment than before treatment （P＆lt;0 .05） .The serum levels of IL‐6 ,TNF‐α,MACE and UAER were sig‐nificantly lower in groups A and B after treatment than before treatment （P＆lt;0 .05 ,P＆lt;0 .01） . The MAGE was positively related with the UAER ,IL‐6 and TNF‐α （r=0 .392 ,P=0 .013 ;r=0.587 ,P=0 .002 ;r=0 .659 ,P=0 .000） .The age ,disease duration ,systolic blood pressure ,and se‐rum levels of HbA1c ,IL‐6 ,TNF‐αand MAGE were the risk factors for proteinuria in T2DM pa‐tients .Conclusion Blood glucose fluctuation is closely related with inflammatory factors which are involved in the occurrence and progress of diabetic nephropathy .

关 键 词：糖尿病肾病 糖尿病 2型 白蛋白尿 白细胞介素6 肿瘤坏死因子Α 胰岛素 血糖 

分 类 号：R587.2[医药卫生—内分泌]