2型糖尿病患者血清趋化素水平与早期肾功能不全的相关性研究  

Association of serum chemerin level with early renal insufficiency in patients with type 2 diabetes

作　　者：金烁烁 陈匡阳 戴嘉融 石洁 鹿斌 张伟伟[2] 杨叶虹 闻杰 胡仁明 杨震[2] 王宣春 Jin Shuoshuo;Chen Kuangyang;Dai Jiarong;Shi Jie;Lu Bin;Zhang Weiwei;Yang Yehong;Wen Jie;Hu Renming;Yang Zhen;Wang Xuanchun(Department of Endocrinology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Endocrinology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China)

机构地区：[1]复旦大学附属华山医院内分泌科,上海200040 [2]上海交通大学医学院附属新华医院内分泌科,上海200092

出　　处：《中华内分泌代谢杂志》2022年第6期509-516,共8页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金(81873645)。

摘　　要：目的评估2型糖尿病患者循环趋化素(chemerin)与肾功能的两个指标[估算的肾小球滤过率(eGFR)和尿白蛋白与肌酐比值(UACR)]之间的相关性, 并确定chemerin是否是2型糖尿病患者早期肾功能不全的独立危险因素。方法本横断面社区研究共招募了742例2型糖尿病患者。测定和收集这些个体的基本信息、人体测量参数和生化参数, 并使用酶联免疫吸附法测定血清chemerin水平。结果 eGFR受损组的chemerin水平显著高于eGFR正常组, 而大量白蛋白尿组的chemerin水平显著高于正常或微量白蛋白尿组。Spearman相关分析显示, 血清chemerin水平与eGFR(r=-0.25,P<0.001)、UACR(r=0.23,P<0.001)及其他生化指标(如三酰甘油)相关。单变量和多变量logistic回归分析(调整相应协变量)显示, 循环chemerin是eGFR受损或蛋白尿的独立危险因素。受试者工作特征(ROC)曲线分析显示, 循环chemerin预测2型糖尿病早期eGFR受损的曲线下面积(AUC)为0.747, 而循环chemerin预测2型糖尿病大量白蛋白尿的AUC为0.748。结论循环chemerin与eGFR或UACR密切相关, 可能是2型糖尿病早期肾功能不全的潜在诊断标志物。Objective To assess the correlation between circulating chemerin and two indicators of renal function,estimated glomerular filtration rate(eGFR)and urine albumin creatinine ratio(UACR),in individuals with type 2 diabetes and to determine whether chemerin is an independent marker of early renal insufficiency.Methods A total of 742 patients with type 2 diabetes were recruited into the cross-sectional community study.Basic information,anthropometric parameters,and biochemical parameters of these individuals were determined and collected,and serum chemerin level was measured using enzyme-linked immunosorbent assay.Results Chemerin levels were significantly higher in the eGFR-impaired group compared with eGFR-normal group,and macroalbuminuria group compared to the normal or microalbuminuria groups.Spearman′rank correlation analysis showed serum chemerin level was correlated with eGFR(r=-0.25,P<0.001),UACR(r=0.23,P<0.001)and some other biochemical indicators such as triglyceride.And univariate and multivariate logistic regression analyses revealed circulating chemerin was an independent risk factor for eGFR impairment or proteinuria after adjusting corresponding covariates.Receiver operating characteristic(ROC)curve analysis showed that the area under curve(AUC)of circulating chemerin for predicting early impaired eGFR in type 2 diabetes was 0.747,while the AUC of circulating chemerin for predicting macroalbuminuria in type 2 diabetes was 0.748.Conclusion Circulating chemerin is associated with eGFR or UACR and may be a potential diagnostic marker for early renal insufficiency in type 2 diabetes.

关 键 词：趋化素 糖尿病 2型 肾小球滤过率 尿白蛋白与肌酐比值 

分 类 号：R587.2[医药卫生—内分泌] R692[医药卫生—内科学]