糖尿病肾病患者水通道蛋白1水平与血管钙化的关系  

Relationship between aquaporin 1 level and vascular calcification in diabetic nephropathy

作　　者：赵宗权 吴贻红 张豪 王小红 汤振源 黄敏[1] Zhao Zongquan;Wu Yihong;Zhang Hao;Wang Xiaohong;Tang Zhenyuan;Huang Min(Department of General Practice,Suzhou Hospital Affiliated to Nanjing Medical University Suzhou Municipal Hospital,Suzhou 215000,China;Department of General Practice,Runda Community Health Service Center Wumenqiao Street Gusu District Suzhou City,Suzhou 215000,China;Department of General Practice,Pingjiang New Town Community Health Service Center,Sujin Street Gusu District Suzhou City,Suzhou 215000,China;Department of Gerontology,Suzhou Hospital Affiliated to Nanjing Medical University Suzhou Municipal Hospital,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院·苏州市立医院全科医学科,苏州215000 [2]苏州市姑苏区吴门桥街道润达社区卫生服务中心全科医学科,苏州215000 [3]苏州市姑苏区苏锦街道平江新城社区卫生服务中心全科医学科,苏州215000 [4]南京医科大学附属苏州医院·苏州市立医院老年医学科,苏州215000

出　　处：《中国医师进修杂志》2024年第9期817-822,共6页Chinese Journal of Postgraduates of Medicine

基　　金：苏州市2022年度第二十八批科技发展计划(医疗卫生科技创新)项目(SKY2022088)。

摘　　要：目的分析糖尿病肾病患者水通道蛋白1(AQP1)水平与血管钙化的关系。方法回顾性选取2020年3月至2023年3月南京医科大学附属苏州医院收治的125例糖尿病肾病患者为病例组,将病例组分为A组(糖尿病肾病Ⅰ期、Ⅱ期)31例,B组(糖尿病肾病Ⅲ期)32例,C组(糖尿病肾病Ⅳ期)39例,D组(糖尿病肾病Ⅴ期)23例,其中发生血管钙化51例,将其作为糖尿病肾病钙化组,未发生血管钙化74例,将其作为糖尿病肾病未钙化组。另选取进行健康体检的志愿者60例为对照组。受试者工作特征(ROC)曲线分析AQP1对糖尿病肾病患者血管钙化的预测价值并探讨糖尿病肾病患者血管钙化的相关因素。结果与对照组比较,A组、B组、C组、D组AQP1水平和钙化率较高[6.41±1.04、7.93±1.23、9.50±1.52、11.37±2.01比3.83±0.56和6.45%(2/31)、28.13%(9/32)、51.28%(20/39)、86.96%(20/23)比0](P<0.05);与A组比较,B组、C组、D组AQP1水平和钙化率较高(P<0.05);与B组比较,C组、D组AQP1水平和钙化率较高(P<0.05);与C组比较,D组AQP1水平和钙化率较高,差异有统计学意义(P<0.05)。与未血管钙化组比较,血管钙化组尿酸、同型半胱氨酸、胱抑素C水平较高[(313.82±38.72)μmol/L比(253.42±30.14)μmol/L、(20.03±3.01)μmol/L比(15.01±2.71)μmol/L、(1.73±0.26)mg/L比(1.30±0.17)mg/L],差异有统计学意义(P<0.05)。AQP1与尿酸、同型半胱氨酸、胱抑素C均呈正相关(P<0.05)。AQP1、尿酸、同型半胱氨酸、胱抑素C在预测糖尿病肾病患者发生血管钙化的曲线下面积分别为0.892、0.803、0.738、0.763。以糖尿病肾病患者是否发生血管钙化为因变量(否=0;是=1),选择单因素分析中P<0.05的变量进行多因素Logistic回归分析,结果显示尿酸、同型半胱氨酸、胱抑素C和AQP1为影响糖尿病肾病患者发生血管钙化的危险因素(P<0.05)。结论血清AQP1对糖尿病肾病患者血管钙化的预测价值较高,有望作为糖尿病肾病患者血管钙化Objective To analyze the relationship between aquaporin 1(AQP1)level and vascular calcification in patients with diabetes nephropathy.Methods A total of 125 diabetic nephropathy patients admitted to Suzhou Hospital of Nanjing Medical University from March 2020 to March 2023 were retrospectively selected as case group.The case group was divided into group A(diabetes nephropathy stageⅠandⅡ)with 31 cases,group B(diabetes nephropathy stageⅢ)with 32 cases,group C(diabetes nephropathy stageⅣ)with 39 cases,and group D(diabetes nephropathy stage V)with 23 cases.In these patients,51 cases had vascular calcification,taken as the calcification group,and 74 cases had no vascular calcification,taken as the non calcification group.Sixty volunteers who underwent health examinations in the same hospital were selected as the control group.Receiver operating characteristic curve was used to analyze the predictive value of AQP1 on vascular calcification in diabetes nephropathy patients and to explore the related factors of vascular calcification in diabetes nephropathy patients.Results Compared with the control group,AQP1 level and calcification rate in groups A,B,C and D were higher:6.41±1.04,7.93±1.23,9.50±1.52 and 11.37±2.01 vs.3.83±0.56 ng/L,6.45%(2/31),28.13%(9/32),51.28%(20/29)and 86.96%(20/23)vs.0(P<0.05).Compared with group A,the level of AQP1 and calcification rate in groups B,C and D were higher(P<0.05);compared with group B,the AQP1 level and calcification rate in groups C and D were higher(P<0.05);compared with group C,the level of AQP1 and calcification rate in group D were higher(P<0.05).Compared to the non calcification group,the levels of uric acid,homocysteine and cystatin C in calcification group were higher:(313.82±38.72)μmol/L vs.(253.42±30.14)μmol/L,(20.03±3.01)μmol/L vs.(15.01±2.71)μmol/L,(1.73±0.26)mg/L vs.(1.30±0.17)mg/L(P<0.05).AQP1 was positively correlated with uric acid,homocysteine,and cystatin C(P<0.05).The area under the curve of AQP1,uric acid,homocysteine and cystatin C in pre

关 键 词：糖尿病肾病 水通道蛋白1 血管钙化 相关性 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]