2型糖尿病肾病患者抵抗素水平及其与血管内皮功能的关系  

Alteration of Serum Resistin and Its Relationship to Vascular Endothelial Function in Type 2 Diabetic Patients with Diabetic Nephropathy

作　　者：刘薇[1] 赖美铮[1] 郭顺华[2] 熊晓清[1] 劳干诚[1] 冉建民[1] LIU Wei;LIAI Mei-zheng;GUO Shun-hua(Department of Endocrinology,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China)

机构地区：[1]暨南大学医学院附属广州市红十字会医院内分泌科,广东广州510220 [2]暨南大学医学院附属广州市红十字会医院超声诊断科,广东广州510220

出　　处：《医学临床研究》2018年第8期1467-1470,共4页Journal of Clinical Research

基　　金：广东省中医药局科研课题（项目编号：20152043）;广州市医药卫生科技项目（项目编号：20152A010003）

摘　　要：[目的]探讨2型糖尿病肾病（DN）患者抵抗素水平的变化及其与血管内皮功能改变的关系.[方法]2型糖尿病患者62例,按24小时尿微量白蛋白分为正常蛋白尿组（NAU组）,微量蛋白尿组（MAU组）,及大量蛋白尿组（CAU组）.空腹检测血清抵抗素和生化指标（血脂、血糖、肝肾功能等）及内皮功能和心室结构指标.内皮功能指标包括肱动脉内皮依赖性舒张功能（FMD）,含服硝酸甘油后肱动脉内皮依赖性舒张功能（NID）,颈动脉内-中膜厚度（IMT）.心室结构指标包括左室内径（LVD）、左室后壁厚度（LWPWT）、室间隔厚度（IVST）.比较各组间上述指标的变化并分析抵抗素与各指标的相关性.[结果]①CAU组NAU组的2倍,明显高于MAU组（P〈0.01和P〈0.05）.②FMD、NID随着抵抗素水平的增加而下降（P〈0.05）.LVD、LWPWT、IVST随着抵抗素水平的升高,明显增加（P〈0.05）.IMT随抵抗素水平的升高有增加的趋势（P〉0.05）.③抵抗素与24 h尿白蛋白排出量、血肌酐、载脂蛋白B、空腹胰岛素水平IVST呈正相关（r值分别为0.281、0.805、0.399、0.33、0.335,均P〈0.05）,与FMD、NID呈负相关（r值为-0.445、-0.338,均P〈0.05）.[结论]糖尿病合并肾病患者抵抗素随24小时尿微量白蛋白的增加而升高,并且与血管内皮功能的损害呈正相关,抵抗素可作为糖尿病肾病患者合并大血管风险的一个早期预测指标.[Objective]To investigate the level of plasma resistin in patients with type 2 diabetic nephropathy （DN） and its relationship with vascular endothelial function. [Methods]According to the amount of 24-hour urinary albumin excretion （UAE）, sixty-two type 2 diabetic patients without clinical macrovascular complications were divided into 3 groups： normal albuminuria group （NAU）,microalbuminuria group （MAU） and macroalbuminuria group （CAU）. Fasting plasma resistin plus other biochemical indexes （blood lipid and sugar level, hepatic and renal function, etc.）, endothelial function, and ventricular structure were measured. Endothelial function indicators including brachial artery endothelium-dependent diastolic function flow-mediated vasodilation （FMD）, nitroglycer- in vasodilation （NID）, and carotid intima-media thickness （IMT） were recorded. Ventricular structure indicators like left ventricular internal diameter （LVD）, left ventricular posterior wall thickness （LVPWT）, and interven- tricular septal thickness （IVST） were detected as well. The changes of the above indicators between the groups were compared and the correlation between resistin and each index was analyzed. [Results]l. In CAU group, plas- ma concentration of resistin was as twice as that in NAU group, which was higher than that in MAU group（ P 〈0.01 and P 〈0.05）. 2. FMD and NID were significantly decreased along with the increase of plasma resistin level （ P〈0.05）, while LVD,LVPWT and IVST values increased significantly with the increase of ressitin level （ P〈 0.05）.IMT had a tendency to increase with the plasm resistin level; however, the difference was not statistically significant（ P〉0.05）.3. Fasting resistin was positively correlated with UAE, SCr, ApoB, FIN, and IVST（ r values were 0.281,0.805,0.399,0.33,0.335, respectively, P 〈0.05）, while resistin level was negatively correlated with FMD. NID （r values were - 0. 445, - 0. 338, respectively, P〈 0.05）. [Conclusio

关 键 词：糖尿病 2型/病理生理学 抵抗素 内皮 血管 

分 类 号：R587.1[医药卫生—内分泌]