总25羟维生素D、IL-6、糖化血红蛋白和尿微量白蛋白/肌酐比值联合检测在2型糖尿病肾病患者中的价值研究  

Study on the Value of Combined Detection of Total 25-(OH) D,IL-6,HbA1c and UmAlb/Ucr Ratio in Patients with Type 2 Diabetic Nephropathy

作　　者：梁妙芝 黄诗茵 潘少霞 王飞马 LIANG Miaozhi;HUANG Shiyin;PAN Shaoxia(Qingyuan Hospital of Traditional Chinese Medicine,Qingyuan 511500,China)

机构地区：[1]广东省清远市中医院,广东清远511500

出　　处：《中国医学创新》2018年第19期8-11,共4页Medical Innovation of China

基　　金：清远市科技项目(2016B069)

摘　　要：目的:研究血清25羟维生素D[25-(OH)D]、白介素-6(IL-6)、糖化血红蛋白(HbA1c)以及尿微量白蛋白/肌酐比值(UmAlb/Ucr)联合检测对2型糖尿病肾病的诊断价值。方法:选取本院2016年10月-2018年1月期间收治的2型糖尿病患者158例作为研究组。其中,无肾病患者49例作为A组,有肾病患者109例作为B组。另选取同期来本院体检的健康志愿者50例作为对照组。对所有对象进行25-(OH)D、IL-6、HbA1c以及UmAlb/Ucr水平检测,分析2型糖尿病患者25-(OH)D与IL-6、HbA1c以及UmAlb/Ucr的关系。另将B组根据UmAlb/Ucr和HbA1c水平将糖尿病肾病患者分为(1)HbA1c正常(≤6.4%)微量蛋白尿组(30~300 mg/g)、(2)HbA1c正常(≤6.4%)大量蛋白尿组(>300 mg/g)、(3)HbA1c偏高(>6.4%)微量蛋白尿组(30~300 mg/g)、(4)HbA1c偏高(>6.4%)大量蛋白尿组(>300 mg/g),检测四个小组患者25-(OH)D与IL-6水平,分析肾功能损伤程度与25-(OH)D与IL-6水平的关系。结果:研究组25-(OH)D水平明显低于对照组,IL-6、HbA1c以及UmAlb/Ucr水平均明显高于对照组,差异均有统计学意义(P<0.05)。不同亚型2型糖尿病患者的HbA1c水平对比,差异无统计学意义(P>0.05);A组患者25-(OH)D水平明显高于B组,IL-6以及UmAlb/Ucr水平均明显低于B组,差异均有统计学意义(P<0.05)。微量蛋白尿组患者25-(OH)D水平明显高于大量蛋白尿组,IL-6明显低于大量蛋白尿组,差异均有统计学意义(P<0.05)。随着HbA1c升高,微量蛋白尿和大量蛋白尿组患者25-(OH)D水平均降低,两者呈负相关(r=-0.729,P=0.000);IL-6水平均升高,两者呈正相关(r=1.316,P=0.000)。结论:2型糖尿病肾病患者血清25-(OH)D水平明显降低,IL-6以及UmAlb/Ucr水平明显升高,联合检测四种指标对2型糖尿病肾病的早期监测和病变程度的预测具有重要作用。Objective:To study the value of combined detection of serum 25-(OH)D,interleukin-6(IL-6),glyeosylated hemoglobin(HbA1c)and micro-albumin/urine creatinine ratio(UmAlb/Ucr)in the diagnosis of type 2 diabetic nephropathy.Method:A total of 158 patients with type 2 diabetes mellitus treated from October 2016 to January 2018 in our hospital were selected as study group.There were 49 patients without nephropathy as group A and 109 patients with nephropathy as group B.Another 50 healthy check-ups were selected as control group.All subjects were detected for 25-(OH)D,IL-6,HbA1c and UmAlb/Ucr,the relationship between 25-(OH)D and IL-6,HbA1c,UmAlb/Ucr in patients with type 2 diabetes mellitus were analyzed.In addition,according to the UmAlb/Ucr and HbA1c levels,Group B were assigned to normal HbA1c(≤6.4%)with micro-albuminuria group(30-300 mg/g),normal HbA1c(≤6.4%)with massive albuminuria group(>300 mg/g),higher HbA1c(>6.4%)with micro-albuminuria group(30-300 mg/g)and higher HbA1c(>6.4%)with massive albuminuria group(>300 mg/g).The 25-(OH)D and IL-6 levels were detected in four groups,and the relationship between the degree of renal function injury and the levels of 25-(OH)d and IL-6 were analyzed.Result:The 25-(OH)D level in the study group was significantly lower than that in the control group,the IL-6,HbA1c and UmAlb/Ucr levels were significantly higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in HbA1c level of patients with different subtype 2 diabetes mellitus(P>0.05);the level of 25-(OH)D in group A was significantly higher than that in group B,the levels of IL-6 and UmAlb/Ucr were significantly lower than those in group B,the differences were statistically significant(P<0.05).The level of 25-(OH)D in the micro-albuminuria group was significantly higher than that in the massive albuminuria group,the level of IL-6 in the micro-albuminuria group was significantly lower than that in the massive albuminuria group,the differences were sta

关 键 词：2型糖尿病肾病 25-(OH)D IL-6 HBA1C UmAlb/Ucr 关系 

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