血清白介素-27浓度在2型糖尿病肾病早期诊断中的作用  

Role of serum interleukin-27 concentration in early diagnosis of type 2 diabetic nephropathy

作　　者：张悦琪 廖晓辉[1] 胡玉栋 杨鹏飞[1] 袁欣[1] 孙玉清 雷建蓉[1] Zhang Yueqi;Liao Xiaohui;Hu Yudong;Yang Pengfei;Yuan Xin;Sun Yuqing;Lei Jianrong(Department of Nephrology,The Second Affiliated Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属第二医院肾内科,重庆400010

出　　处：《重庆医科大学学报》2020年第5期575-579,共5页Journal of Chongqing Medical University

摘　　要：目的:评估2型糖尿病及糖尿病肾病(diabetic nephropathy,DN)患者血清中白介素-27(interleukin27,IL-27)的水平及意义。方法:根据患者尿蛋白水平,将116例2型糖尿病(type 2 diabetes,T2D)患者分为糖尿病正常尿白蛋白组(DN0组)、早期糖尿病肾病组(DN1组)及临床糖尿病肾病组(DN2组),另外选取健康者作为对照组(H组),采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测各组IL-27水平;全自动生化仪检测超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、尿白蛋白/肌酐、血清肌酐、甘油三酯、总胆固醇水平;高效液相色谱检测法检测糖化血红蛋白水平;化学发光法检测C肽水平;并分析血清中IL-27浓度与上述指标的相关性。结果:与H组[546.200 (411.600,639.250) pg/mL]相比,DN0组[788.200(594.500,1 010.950) pg/mL]患者血清中IL-27浓度明显升高,差异具有统计学意义(P=0.003);DN1组[990.780 (811. 480,1237.830) pg/mL]IL-27浓度较DN0浓度明显升高,差异具有统计学意义(P=0.028);DN2组[1213.300(996.450,1 546.200) pg/mL] IL-27浓度较DN1浓度明显升高,差异具有统计学意义(P=0.037)。IL-27血清浓度与尿蛋白(r=0.580,P=0.000)、血肌酐(r=0.257,P=0.002)、糖化血红蛋(r=0.343,P=0.000)、血清hs-CRP(r=0.431,P=0.000)、空腹血糖浓度(r=0.334,P=0.000)呈正相关关系;与甘油三酯、总胆固醇、血清C肽无明显相关性(P>0.05);IL-27作为DN患者血清标志物的潜能较hs-CRP作为诊断DN的潜能更大,两者联合诊断效能进一步增加。结论:IL-27的血清浓度与2型糖尿病患者DN的发展有关,IL-27可为DN患者早期诊断提供依据。Objective:To assess the level and significance of interleukin-27(IL-27)in patients with type 2 diabetes mellitus(T2D)and diabetic nephropathy(DN).Methods:A total of 116 patients with T2D were divided into diabetic normal urinary albumin group(DN0 group),early diabetic nephropathy group(DN1 group)and clinical diabetic nephropathy group(DN2 group)in accordance with urinary protein;healthy people were selected as the control group(H group).Level of IL-27 was detected by enzyme-linked im-munosorbent assay(ELISA).Hypersensitive C-reactive protein(hs-CRP),urinary albumin/creatinine,serum creatinine,triglyceride and total cholesterol were detected by automatic biochemical analyzer;glycosylated hemoglobin level was detected by high performance liquid chromatography;C-peptide level was detected by chemiluminescence;correlation between serum IL-27 concentration and those above indicators was analyzed.Results:IL-27 serum concentration of patients in the DN0 group[788.200(594.500,1010.950)pg/mL]was significantly higher than that in the H group[546.200(411.600,639.250)pg/mL],with statistically significant difference(P=0.003).IL-27 concentration in the DN1 group[990.780(811.480,1237.830)pg/mL]was significantly higher than that in the DN0 group,with statistically significant difference(P=0.028).IL-27concentration in DN2 group[1213.300(996.450,1546.200)pg/mL]was significantly higher than that in the DN1 group,with statistically significant difference(P=0.037).IL-27 serum concentration had a positive relationship with urine pro-tein(r=0.580,P=0.000),serum creatinine(r=0.257,P=0.002),gly-cosylated hemo-globin(r=0.343,P=0.000),serum hs-CRP(r=0.431,P=0.000)and fasting blood glucose concentration(r=0.334,P=0.000);had no significant correlation with triglyceride,total cholesterol and serum C-peptide(P>0.05).IL-27,as a serum marker of DN patients,had a higher potency than hs-CRP;combination of two markers was able to increase the diagnostic efficiency.Conclusion:Serum concentration of IL-27 is associated with the development of DN in p

关 键 词：2型糖尿病 糖尿病肾病 白介素-27 超敏C反应蛋白 

分 类 号：R692.9[医药卫生—泌尿科学]