糖尿病肾病患者血清铁代谢指标与尿蛋白排泄量相关性分析  

Correlation between serum iron metabolism index and urine protein excretion in patients with diabetic nephropathy

作　　者：徐琳[1] 贺菲菲 XU Ling;HE Feifei(Department of Endocrinology,the Fourth Hospital of Xi’an (Xi’an 710004))

机构地区：[1]西安市第四医院内分泌科

出　　处：《陕西医学杂志》2019年第10期1281-1284,共4页Shaanxi Medical Journal

基　　金：陕西省社会发展科技攻关项目(2016SF-123)

摘　　要：目的:观察不同尿蛋白排泄量糖尿病肾病(DN)患者血清铁代谢指标的水平变化,探讨血清铁代谢指标在DN患者中的监测意义。方法:依据尿微量白蛋白与肌酐比值将106例DN入选者分为尿蛋白正常组、尿蛋白微量组和尿蛋白大量组;选择同期健康体检者40例作为对照组。测定各组受试者血清铁(Fe)、铁蛋白(SF)、转铁蛋白(TRF)、可溶性转铁蛋白受体(sTfR)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、血尿酸、24h尿蛋白排泄量,计算尿蛋白排泄率(UAER)。结果:两两组间对比,尿蛋白正常组Fe、TRF水平低于对照组(P<0.05),尿蛋白微量组低于尿蛋白正常组和对照组(P<0.05),尿蛋白大量组低于其它3组(P<0.05);尿蛋白正常组SF、sTfRFBG、HbAlc、血尿酸和UAER水平高于对照组(P<0.05),尿蛋白微量组高于尿蛋白正常组和对照组(P<0.05),尿蛋白大量组高于其它3组(P<0.05)。血清Fe与FBG、HbAlc、血尿酸和UAER均呈明显负相关,SF与FBG、HbAlc、血尿酸和UAER均呈明显正相关,TRF与HbAlc和UAER呈明显负相关,sTfR与HbAlc、血尿酸和UAER均呈明显正相关(P<0.05)。结论:DN患者体内铁代谢指标随UAER增加而变化,因此可作为预测DN发生发展的预测指标,有利于疾病早期干预和患者预后改善。Objective:To observe the changes of serum iron metabolism index in patients with diabetic nephropathy(DN)with different urinary protein excretion,and to explore the monitoring significance of serum iron metabolism index in patients with DN.Methods:106 patients with DN were divided into normal urine protein group,urine protein micro group and urine protein large group according to the ratio of microalbuminuria to creatinine.40 healthy subjects in the same period were selected as the control group.Serum iron(Fe),ferritin(SF),transferrin(TRF),soluble transferrin receptor(sTfR),fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),blood uric acid,24h urinary protein excretion weremeasured in each group,and calculate urinary protein excretion rate(UAER).Results:The levels of Fe and TRF in the normal urine protein group were lower than those in the control group(P<0.05),the urine protein micro group was lower than the normal urine protein group and the control group(P<0.05),and the urine protein mass group was lower than the other groups(P<0.05);the lever of SF,sTfR FBG,HbAlc,serum uric acid and UAER levels in urinary protein normal group were higher than the control group(P<0.05),urine protein micro group was higher than urine protein normal group and control group(P<0.05),the urine protein in the large group was higher than the other three groups(P<0.05).Serum Fe was negatively correlated with FBG,HbAlc,serum uric acid and UAER;SF was positively correlated with FBG,HbAlc,serum uric acid and UAER;TRF was negatively correlated with HbAlc and UAER;sTfR and HbAlc,blood uric acid and UAER showed a significant positive correlation(P<0.05).Conclusion:The iron metabolism index in patients with DN changes with the increase of UAER,so it can be used as a predictor for predicting the development of DN,which is beneficial to early intervention of disease and improvement of patient prognosis.

关 键 词：糖尿病肾病 尿蛋白 血清铁 铁蛋白 转铁蛋白 相关性 

分 类 号：R587.2[医药卫生—内分泌]