糖尿病肾病患者血清脂联素、尿微量白蛋白的相关性分析  

The correlation analysis of adiponectin and urinary albumin in diabetic nephropathy patients

作　　者：潘金英[1] 黄波[1] 成蔚[1] 刘玲玲[1] 周伟东[1] 

机构地区：[1]南方医科大学珠江医院肾内科,广东广州510282

出　　处：《热带医学杂志》2015年第3期303-306,共4页Journal of Tropical Medicine

基　　金：广东省佛山市医学类科技攻关项目(2014AB002483)

摘　　要：目的探讨糖尿病肾病（DN）患者血清脂联素（ADPN）与尿微量白蛋白（UMA）的变化及二者联合检测在DN诊断中的价值。方法选取DN患者100例,以评估的肾小球滤过率eGFR≥60、60-15、≤15 ml/[min·（1.73 m^2）]将患者分为早期、中期、晚期三组,采用酶联免疫吸附法（ELISA）检测受检者可溶性血管细胞黏附分子1（sVCAM-1）及血清脂联素。同时收集患者临床资料和生化指标、24 h尿中尿微量白蛋白（UMA）、心脏超声检查测量心脏腔径及左心室质量指数（LVMI）。结果早期、中期、晚期三组中高密度脂蛋白胆固醇（HDL-C）、血红蛋白（Hb）、白蛋白（Alb）水平随eGFR降低而下降,ADPN、sVCAM-1、LVMI、UMA、血肌酐（Scr）水平随着eGFR降低而逐渐升高,三组间差异有统计学意义（P〈0.05）;ADPN与Scr、sVCAM-1、LVMI、UMA呈正相关,与Hb、Alb、HDL-C呈负相关;UMA与糖尿病病程、Scr、ADPN、sVCAM-1、LVMI呈正相关,与HDLC、Alb呈负相关。结论脂联素及尿微量白蛋白可能参与DN的发生、发展,二者联合检测对于诊断早期DN有意义。Objective To explore the changes of serum adiponectin（ADPN） and urinary albumin（UMA） in diabetic nephropathy, and the value of combined detection in the diagnosis of early diabetic nephropathy. Methods A total of100 patients with DN were enrolled in this study.The patients were divided into three groups by estimated glomerular filtration rate（eGFR） ： ≥60, 60-15, and ≤15 ml·min^-1·（1.73 m^2）^-1. Serum levels of adiponectin and soluble vascular cell adhesion molecule-1（sVCAM-1） were measured by enzyme linked immunosorbent assay（ELISA）.Clinical data,biochemical indicators and 24 h urinary albumin level were collected.Cardiac ultrasound measurement of cardiac lumen diameter parameters and left ventricular mass index were assessed by echocardiography. Results The levels of serum HDLC, Hb and Alb had a downward trend with the decrease of eGFR;the levels of serum ADPN, sVCAM-1, LVMI,UMA and Scr had a rising trend with the decrease of eGFR.Those biochemical index were statistically significant different among the three groups. The level of serum ADPN was positively correlated with sVCAM-1, LVMI, UMA and Scr,while it was negatively correlated with Hb, Alb and HDLC. Level of UMA was positively correlated with disease course, Scr,ADPN, sVCAM-1 and LVMI,and was negatively correlated with HDLC and Alb. Conclusion Adiponectin and urinary albumin may play important roles in the pathogenesis and development of DN,and combined detection might be useful to be applied in the diagnosis of early diabetic nephropathy.

关 键 词：脂联素 尿微量白蛋白 糖尿病肾病 

分 类 号：R587.2[医药卫生—内分泌]