2型糖尿病患者血清Nampt与胰岛素抵抗及不同尿白蛋白排泄率的相关性研究  

The changes of serum Nampt levels and its correlation in type 2 diabetes patients with different stages of urinary albumin and insulin resistance

作　　者：安丽[1] 马小羽[1] 王晓宇[1] 任慧雯[1] 于菁[1] 王秋月[1] 吕川[1] 

机构地区：[1]中国医科大学附属第一医院内分泌科,沈阳110001

出　　处：《中华内分泌代谢杂志》2016年第9期759-762,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：辽宁省高等学校“高端人才队伍建设工程”项目（项目编号[2014]187）

摘　　要：探讨2型糖尿病患者血清烟酰胺磷酸核糖转移酶（Nampt）、白细胞介素-1β（IL-1β）与胰岛素抵抗及不同尿白蛋白排泄率的相关性。选择321例2型糖尿病患者作为实验组进行研究，根据尿白蛋白/肌酐比率（UACR）分为3组：正常白蛋白尿组（UACR〈30 mg/g，110例）、微量白蛋白尿组（UACR 30～300 mg/g，106例）、大量白蛋白尿组（UACR〉300 mg/g，105例）；采用酶联免疫吸附法检测血清Nampt、IL-1β水平，另设105名为对照组。在上述实验组中筛选出未经胰岛素治疗的糖尿病患者98例，与上述对照组比较，根据空腹血糖及胰岛素水平得出稳态模型评估的胰岛素抵抗指数（HOMA-IR）、定量胰岛素敏感性检测指数（QUICKI）、稳态模型评估的胰岛β细胞功能指数（HOMA-β），比较2组间Nampt、IL-1β、HOMA-IR、QUICKI、HOMA-β等的差异。结果显示大量白蛋白尿组血清Nampt、IL-1β水平明显高于其他3组（均P〈0.05）；微量白蛋白尿组血清Nampt明显高于正常白蛋白尿组（P〈0.05）；Nampt与HbA1C、空腹血糖、空腹胰岛素、三酰甘油、尿酸、IL-1β呈正相关（均P〈0.01），与高密度脂蛋白胆固醇呈负相关（P〈0.01）；糖尿病组血清Nampt、IL-1β明显高于对照组（均P〈0.05）；Nampt与HOMA-IR呈正相关（P〈0.05），与HOMA-β、QUICKI呈负相关（P〈0.05）。Nampt、IL-1β水平与糖尿病肾脏疾病（DKD）的病理进展过程可能存在一定相关性，有可能作为DKD肾损伤的检测指标，两者之间可能存在相互作用，并同时参与DKD的发生、发展。Nampt水平可在一定程度上反映2型糖尿病患者胰岛β细胞功能状态及胰岛素抵抗水平。To explore the correlation between serum nicotinamide phosphoribosyhransferase （ Nampt ） , interleukin -1β （ IL-1β ） and different stages of urinary albumin. 321 patients with type 2 diabetes were divided into 3 groups according to urinary albumin to ereatinine ratio （ UACR ） ： normoalbuminuric group （ UACR 〈 30 mg/g, n = 110 ） , microalbuminuric group （ UACR 30-300 mg/g, n = 106 ） , and macroalbuminuric group （ UACR 〉 300 mg/g, n = 105 ）. The levels of serum Nampt and IL-1β were measured by enzyme linked immunosorbent assay in all the cases and 105 control subjects. 98 patients without insulin therapy were screened out of 321 patients with type 2 diabetes as a new observation group, then compared with control group. Homeostasis model assessment for insulin resistant （HOMA-IR） , quantitative insulin sensitivity check index （QUICKI） , homeostasis model assessment for 13 cell function index （ HOMA-β ）were calculated according to fasting plasma glucose and fasting insulin, then compared the levels of Nampt, IL-1β, HOMA-IR, QUICKI, HOMA-β between diabetes group and control group. The serum levels of Nampt and IL-1β in macroalbuminuric group were significantly higher than those in the other three groups （ all P〈 0.05 ） ; The serum levels of Nampt in microalbuminuric group were significantly higher than those in the other groups （ all P〈 0.05 ） ; The serum level of Nampt was positively correlated with HbAlc, fasting plasma glucose, fasting insulin, triglyeeride, uric acid, IL-113, while negatively correlated with high density lipoprotein-eholesterol （all P〈 0.01 ） ; The serum levels of Nampt and IL-1β were significantly higher than those in diabetes group（ both P〈0.05 ） ; Nampt was positively correlated with HOMA-IR （ P〈0.05 ）, while negatively correlated with HOMA-β and QUICKI （ both P〈0.05 ）. Nampt and IL-1β can be used as indicators of diabetic kidney disease （DKD） , there would be some interactions between them, and at the s

关 键 词：糖尿病肾脏疾病 胰岛素抵抗 烟酰胺磷酸核糖转移酶 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]