摘要
目的探讨尿微量清蛋白(mAlb),尿β2微球蛋白(β2-MG)在2型糖尿病肾病(DN)中的变化及与胰鸟素抵抗(IR)的关系。方法检测95例2型糖尿病(T2DM)患者和25例健康体检者的尿mAlb、尿β2-MG、空腹血糖(FPG)、空腹胰岛素(F1NS),用改进稳态模型计算胰岛素抵抗指数(Homa-IR),观察各指标在不同病程中的变化,比较相同病程中各指标阳性率,分析Homa-IR与尿mAlb和β2-MG的相关性。结果糖尿病组mAlb、β2-MG、FPG、F1NS和Homa-IR显著高于对照组;10年以上病程各指标均显著高于5年以下病程,5～10年病程的mAlb、β2-MG和FPG也显著高于5年以下病程,差异有统计学意义(P<0.01,P<0.05);5～10年病程和10年以上病程各指标阳性率差异无统计学意义,但5年以下病程中β2-MG阳性率显著高于mAlb、F1NS和Homa-IR的阳性率也显著高于mAlb,差异有统计学意义(P<0.01);Homa-IR与尿mAlb和β2-MG呈正相关。结论IR与T2DM肾损伤的尿微量蛋白有关,尿mAlb和β2-MG是早期诊断DN的灵敏指标,在DN初期,尿β2-MG灵敏度高于尿mAlb。
Objective To investigate the changes of mAIb and β2-MG in diabetes nephropathy（DN）and their relationship with insulin resistance（IR）. Methods The mAlb and β2-MG in urine and the blood glucose（FPG）and the blood insulin（FINS）from 95 patients with type 2 diabetes and 25 normal healthy subjects were measured. Homa-IR was calculated. The correlations between Homa-IR and mAlb and β2-MG were analyzed. Results There were significantly higher mAlb,β2-MG,FPG,FINS and Homa-IR in diabetes patients than normal healthy subjects. Furthermore,above all indexes were higher in diabetes patients lasting for 〉 10 years than those for 〈5 years. The mAlb and β2-MG and FPG were also higher in the patients lasting from 5 to 10 years（P〈0.01 ,P〈 0.05）. The positive rate of above all indexes had not significant difference among above groups of different courses of diabetes. But the positive rate of β2-MG was higher than that of mAlb in the patients lasting for 〈5 years,also of FINS and Homa-IR than that of mAlb（P〈0.01）. There was a positive correlation between Homa-IR and urine mAIb,also between Homa-IR and urine β2-MG. Conclusion IR is related to renal damage of type 2 diabetes（T2DM）. Urine mAlb and β2-MG are the sensitive indexes of early diagnosis of DN. The sensitive degree of urine β2-MG is higher than that of urine mAIb in the early phase of DN.
出处
《重庆医学》
CAS
CSCD
2007年第16期1632-1633,1635,共3页
Chongqing medicine
