2型糖尿病肾病不同分期血清N端骨钙素、I型胶原氨基端延长肽、β-胶原降解产物的变化  

The serum levels of N-MID,PINP,and β-CTX in patients with different stage of diabetic nephropathy

作　　者：迟海燕[1] 周玉萍[1] 王永笛 

机构地区：[1]山东省威海市立医院内分泌科,山东威海264200

出　　处：《中国骨质疏松杂志》2015年第7期855-857,865,共4页Chinese Journal of Osteoporosis

摘　　要：目的观察2型糖尿病肾病不同分期血清N端骨钙素(N-MID)、I型胶原氨基端延长肽(PINP)、β-胶原降解产物(β-CTX)水平的变化。方法收集2型糖尿病患者108例,根据尿微量白蛋白/肌酐比值及血清肌酐水平分为无微量蛋白尿组,微量白蛋白尿组,临床蛋白尿组,肾功能不全代偿组和肾功能不全失代偿组。记录其年龄、性别、病程、身高、体重、腰围、体重指数(BMI),测定血清N-MID、PINP、β-CTX水平。结果糖尿病肾病组的年龄、性别构成、腰围、臀围及BMI与无糖尿病肾病组比较,差别无统计学意义(P>0.05),而病程在各组间差别有统计学意义(P<0.05),其中微量白蛋白尿组病程最短为(8.3±3.5)年,肾功能不全失代偿组最长为(18.9±7.4)年。糖尿病肾病组的血清N-MID和PINP水平降低(P<0.05),随着糖尿病肾病分期的进展,血清N-MID和PINP水平有逐渐降低的趋势,但差别无统计学意义(P>0.05)。糖尿病肾病组的血清β-CTX较无糖尿病肾病组增高,差别有统计学意义(P<0.05),肾功能不全失代偿期时进一步明显增高,为(519.49±89.65)pg/ml。结论糖尿病肾病可引起骨的吸收增加,形成减少,通过监测骨代谢指标,有助于糖尿病肾病患者骨质疏松的早期诊断和干预,减少发生骨质疏松骨折的风险。Objective To investigate the levels of N-bone-gamma-carboxyglutamic-acid-containing proteins（ N-MID）,total Nterminal propeptide of type I collagen（ PINP）,and β-C-terminal telopeptides of type I collagen（ β-CTX） in patients with different stage of diabetic nephropathy. Methods A total of 108 patients with type 2 diabetes were collected. They were divided into no proteinuria group,trace proteinuria group,proteinuria group,compensatory renal insufficiency group,and incomplete compensation of renal function group,according to urinary albumin creatinine ratio and levels of serum creatinine. Their age,sex,duration of diabetes,height,weight,waistline,hipline,and BMI were recorded. The levels of N-MID,PINP,and β-CTX in their serum were detected. Re sults The age,sex,waistline,hipline,and BMI showed no significant difference between patients with and without diabetic nephropathy（ P〈0. 05）. The duration of diabetes was different among the groups（ P〈0. 05）,which was the shortest（ 8. 3 ± 3. 5 years） in trace proteinuria group and the longest（ 18. 9 ± 7. 4 years） in incomplete compensation of renal function group. The levels of N-MID and PINP decreased in patients with diabetic nephropathy. With the development of the disease,they decreased continuously,but with no statistical significance（ P〉0. 05）. The serum level of β-CTX in diabetic nephropathy patients was higher than that in non nephropathy patients（ P〈0. 05）. It increased further in the stage of incomplete compensation of renal function. Conclusion Diabetic nephropathy causes increase of bone resorption and decrease of bone formation. Monitoring of bone metabolic markers may contribute to the early diagnose and treatment of osteoporosis in diabetic nephropathy patients,and may decrease the risk of osteoporotic fractures.

关 键 词：糖尿病肾病 N端骨钙素 I型胶原氨基端延长肽 β-胶原降解产物 

分 类 号：R459.9[医药卫生—治疗学]