不同尿白蛋白/肌酐比值的2型糖尿病患者血清溶血磷脂酸与骨桥蛋白、转化生长因子β1相关性的研究  

Correlation between serum LPA/OPN and TGF-β1 in type 2 diabetic patients with different urinary albumin/creatinine ratio

作　　者：袁紫东 周阳[1] 王怡丽 康嘉懿 刘思若 王秋月[1] YUAN Zidong;ZHOU Yang;WANG Yili(Department of Endocrinology and Metabolism,The First Affiliated Hospital of China Medial University’Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院内分泌与代谢病科,沈阳110001

出　　处：《中国糖尿病杂志》2021年第11期816-821,共6页Chinese Journal of Diabetes

基　　金：国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项(2018YFC1313900、2018YFC1313901)。

摘　　要：目的分析不同UACR的T2DM患者血清溶血磷脂酸(LPA)与骨桥蛋白(OPN)、TGF-β1的相关性,探讨DKD早期标志物。方法选取2018年3月至2019年12月于中国医科大学附属第一医院内分泌与代谢病科就诊的T2DM患者313例,根据UACR分为正常白蛋白尿组(N-UAlb,n=105)、微量白蛋白尿组(M-UAlb,n=105)及大量白蛋白尿组(L-UAlb,n=103)。另选取同期体检健康者104名为正常对照(NC)组。ELISA法测定各组LPA、OPN和TGF-β1水平。结果 NC、N-UAlb、M-UAlb、L-UAlb组血清LPA、OPN、TGF-β1水平依次升高(P<0.05)。Pearson相关分析显示,血清LPA与SBP、DBP、HbA1c、TG、TC、血尿酸、OPN和TGF-β1水平呈正相关(P<0.05或P<0.01),与HDL-C呈负相关(P<0.01)。多元线性逐步回归分析结果显示,TG、HbA1c、UACR、OPN、TGF-β1是LPA的影响因素。结论 LPA可能是DKD早期诊断的新型生物标志物;血清LPA水平与OPN、TGF-β1呈正相关,LPA、OPN及TGF-β1相互作用,共同参与DKD发生发展。Objective To investigate the correlation between serum lysophosphatidic acid(LPA),osteopontin(OPN)and transforming growth factor-β1(TGF-β1)in patients with type 2 diabetes mellitus(T2 DM)and different urinary albumin/creatinine ratio(UACR).Methods A total of 313 patients with T2 DM were enrolledin the Department of Endocrinology and Metabolism of The First Affiliated Hospital of China Medical University from March 2018 to December 2019. All the patients were divided into normal albuminuria group(N-UAlb,UACR<30 mg/g,n=105),microalbuminuria group(M-UAlb,UACR 30~300 mg/g,n=105),large albuminuria group(L-UAlb,UACR> 300 mg/g,n=103)according to the UACR. Meanwhile,104 healthy subjects were selected as control group(NC). ELISA was used to determine LPA,OPN and TGF-β1.Results Serum LPA,OPN,and TGF-β1 levels increased sequentially in N-UAlb,M-UAlb,and L-UAlb groups,and all the above were higher than in NC group(P<0. 05). Pearson correlation analysis showed that serum LPA level was positively correlated with SBP,DBP,Hb A1 c,TG,TC,SUA,OPN,and TGF-β1 levels(P<0. 05 or P<0. 01),while negatively correlated with HDL-C level(P<0. 01). Multiple linear stepwise regression analysis showed that TG,Hb A1 c,UACR,OPN,and TGF-β1 were independent risk factors for LPA.Conclusion LPA may be a new biomarkerinearly diagnosis of DKD. LPA level is positively correlated with OPN and TGF-β1 levels,indicating that there may be an interaction between LPA,OPN and TGF-β1,which jointly participate in the occurrence and development of DKD.

关 键 词：糖尿病肾脏疾病 溶血磷脂酸 骨桥蛋白 转化生长因子Β1 

分 类 号：R587.1[医药卫生—内分泌]