2型糖尿病肾病患者临床分期与骨质疏松及生长因子的关系  

Relationship of Clinical Stage in Patients with Type 2 Diabetic Nephropathy with Osteoporosis and Growth Factors

作　　者：韩冬梅 毛维维 巩伟伟 李晗 周蒨 HAN Dong-mei;MAO Wei-wei;GONG Wei-wei(Shanghai First Rehabilitation Hospital,Shunghai,200090)

机构地区：[1]上海市第一康复医院,上海200090

出　　处：《医学临床研究》2020年第9期1297-1299,共3页Journal of Clinical Research

基　　金：上海市科学技术委员会资助项目(13DZ1941603)。

摘　　要：[目的]探讨2型糖尿病肾病(DN)患者临床分期与骨质疏松及生长因子的关系。[方法]在本院接受治疗的200例2型糖尿病DN患者(观察组),根据尿白蛋白排泄率(UAE)将患者分为A组(正常白蛋白尿,UAE<20 μg/min)、B组(微量白蛋白尿,UAE为20-200 μg/min).C组(大量白蛋白尿.UAE>200 μg/min)及D组[终末期肾衰竭,肾小球滤过率(GFR)<10 mL/min]。选取同期本院健康体检者50例作为对照组。观察研究对象骨质疏松及生长因子相关指标水平。[结果]观察组松质骨骨密度及骨矿含量、皮质骨骨密度及骨矿含量均低于对照组(P均<0.05).松质骨T值及皮质骨T值均高于对照组(P均<0.05)。观察组各亚组间骨密度及生长因子指标相比较差异均有显著性(P<0.05);D组松质骨骨密度及骨矿含量、皮质骨骨密度及骨矿含量低于A.B,C组.松质骨T值及皮质骨T值高于A、B,C组(均P<0.05)。观察组成纤维细胞生长因子-23(FGF-23)、白细胞介素-6(IL-6)水平高于对照组,胰岛素样生长因子-Ⅱ(IGF-Ⅱ)、表皮生长因子(EGF)、转化生长因子-BKTGFβ低于对照组(均P<0.05)。D组FGF-23,IL-6高于A、B、C组,IGF-Ⅱ、EGF、TGF-β低于A、B、C组(均P<0.05);C组FGF-23、IL-6高于A、B组,IGF-Ⅱ、EGF,TGF-β低于C组(均P<0.05)。[结论]2型糖尿病DN恋者病情严重程度与骨质疏松及生长因子密切相关.DN患者骨质疏松的发生可能与生长因子相关。[Objective]To investigate the relationship of clinical stage with osteoporosis and growth factors in patients with type 2 diabetic nephropenthy(DN).[Methods]A total of 200 patients with type 2 diabetic nephropathy,who received treatment in our hospital,were selected as the observation group.According to the value of albumin excretion rate(UAE),patients were divid-ed into group A(normal albuminuria.UAE<20 μg/min),group B(microalbuminuria,UAE 20-200μg/min),group C(large amount of albuminuria,UAE>200μg/min)and group D(end stage renal failure.GFR<10 mL/min).In the same time period,50 healthy volunteers were enrolled as the control group.The levels of osteoporosis and growth factor related indicators were evalu-ated.[Results]The bone mineral density and mineral content of both cancellous and cortical bones in the observation group were lower than those in the control group(P<0.05).The T value of the cancellous bone and the corticnl bone were higher than those of the control group(P<0.05).There were significant differences in bone mineral density and growth factor indicators among the subgroups of the observation group(P<0.05).The cancellous and cortical bone mineral density and mineral content in group D were lower than those in group A,B and C,while the T value of the canellous bone and the cortical bone were higher than those in group A,B and C(P<0.05).The levels of FGF-23 and IL-6 in the observation group were higher than those in the control group,and IGF-Ⅱ,EGF and TGF plevels were lower tham those in the control group(P<0.05).The levels of FGF 23 and IL-6 in group D were higher than those in group A.B and C,and IGF-Ⅱ,EGF and TGF-βwere lower than those in group A,B and C(P<0.05).The levels of FGF-23 and IL-6 in group C were higher than those in group A and B.and IGF-Ⅱ.EGF and TGF-βwere lower than those in group A and B(P<0.05).[Conclusion]The severity of DN in patients with type 2 diabetes is closely related to osteoporosis and growth factors.The occurrence of osteoporosis in DN patients may be related

关 键 词：糖尿病 2型/并发症 糖尿病肾病 骨质疏松 胞间信号肽类和蛋白质类 

分 类 号：R587.24[医药卫生—内分泌]