血浆生长分化因子-15水平与2型糖尿病肾病分期的相关性研究  

Correlation between plasma growth differentiation factor-15 and staging of type 2 diabetic nephropathy

作　　者：阮园[1] 王绍冠[1] 王溢苏[1] 王芳[2] 吴天凤[1] RUAN Yuan;WANG Shaoguan;WANG Yisu;WANG Fang;WU Tianfeng(Department of Endocrinology,Zhejiang Hospital,Hangzhou 310013,China)

机构地区：[1]浙江医院内分泌科,浙江杭州310013 [2]浙江医院医学检验科,浙江杭州310013

出　　处：《全科医学临床与教育》2018年第2期137-140,共4页Clinical Education of General Practice

基　　金：浙江省医药卫生科技计划资助项目(2014KYB008)

摘　　要：目的探讨血浆生长分化因子-15(GDF-15)在2型糖尿病肾病不同分期患者中的表达水平和临床意义。方法选取2型糖尿病患者81例和同期体检健康对照组29例。根据Mogensen分期标准,2型糖尿病患者分为正常白蛋白尿组30例、微量白蛋白尿组28例、大量白蛋白尿组23例。采集各组一般临床资料和各组糖化血红蛋白(Hb A1C)、血肌酐(Scr)、甘油三酯(TG)、总胆固醇(TCH)、低密度脂蛋白胆固醇(LDL-C)指标,检测血浆GDF-15,分析GDF-15与糖尿病肾病的相关性。结果大量白蛋白尿组GDF-15明显高于糖尿病微量白蛋白尿组、糖尿病正常蛋白尿组和对照组(q分别=10.60、14.41、15.84,P均<0.05)。微量白蛋白尿组GDF-15水平分别高于正常尿蛋白组和对照组(q分别=4.93、4.57,P均<0.05)。大量白蛋白尿组e GFR明显低于糖尿病微量白蛋白尿组、糖尿病正常白蛋白尿组和对照组(q分别=5.90、5.71、5.59,P均<0.05)。多元回归分析显示:GDF-15、e GFR分别与24 h尿微量白蛋白(24 h m Alb)具有独立相关性(t分别=2.07、-2.06,P均<0.05)。结论 GDF-15具有早期诊断糖尿病肾病和病情程度评估的临床价值。Objective To explore the expressions of plasma growth differentiation factor-15(GDF-15)in the patients with different stages of type 2 diabetic nephropathy.Methods Eighty-one cases of type 2 diabetic and twenty-nine cases of healthy volunteers for controlling were selected.The patients with type 2 diabetic were divided into normal albuminuria group with 30 cases,microalbuminuria with 28 cases and macroalbuminuria group with 23 cases according to Mogensen’s criteria.General data,HbA1C,serum creatine,triglyceride,cholesterol,low density lipoprotein cholesterol and GDF-15 were measured and the correlation between GDF-15 and diabetic nephropathy was analyzed.Results The GDF-15 of the macroalbuminuria group was significantly higher than that of microalbuminuria group,normal albuminuria group and control group(q=10.60,14.41,15.84,P<0.05).The GDF-15 of the microalbuminuria group was significantly higher than that of normal albuminuria group and control group(q=4.93,4.57,P<0.05).The eGFR of the macroalbuminuria group was significantly lower than that of microalbuminuria group,normal albuminuria group and control group(q=5.90,5.71,5.59,P<0.05).Multivariate linear regression analysis showed that plasma GDF-15 level and eGFR were risk factors for mAlb level in 24 hours(t=2.07,-2.06,P<0.05).Conclusion GDF-15 has the clinical value of early diagnosis of diabetic nephropathy and evaluation for progression of the disease.

关 键 词：2型糖尿病 糖尿病肾病 生长分化因子-15 

分 类 号：R587.2[医药卫生—内分泌]