摘要
目的观察2型糖尿病早期肾病尿蛋白与炎性因子的相关性。方法 2型糖尿病共90例,其中早期糖尿病肾病(DN)组60例,初次诊断2型糖尿病但无蛋白尿(DM)组30例,健康者(NC组)30名。采用全自动生化分析仪测定血糖、血脂、血肌酐(SCr)、C反应蛋白(CRP)等,采用干式化学法测定24 h尿蛋白,放免法测定尿白蛋白排泄率(UAER),酶联免疫吸附试验(ELISA)法测定血清转化生长因子β1(TGF-β_1)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、IL-18。结果①DM组、DN组的TNF-α、IL-6、IL-18、TGF-β_1、CRP水平均显著高于NC组(P值分别<0.05、0.01),而DN组与DM组间的差异均有统计学意义(P值分别<0.05、0.01)。②将DM、DN组的所有患者合并计算,UAER与血清TGF-β_1(r=0.285)、CRP(r=0.317)、TNF-α(r=0.658)、IL-6(r=0.556)、IL-18(r=0.392)、24 h尿蛋白(r=0.514)、尿白蛋白/肌酐(ALB/Cr)(r=0.691)、病程(r=0.806)均呈正相关(P值分别<0.05、0.01)。多元逐步回归分析显示,UAER与病程、TNF-α、24 h尿蛋白呈线性回归关系,回归方程为UAER=(-12.132)+(0.449)病程+(0.692)TNF-α+(78.971)24 h尿蛋白。结论 2型糖尿病及糖尿病早期肾病患者相关血清炎性因子水平升高,炎症参与糖尿病肾病的发生、发展。
Objective To investigate the correlation between urine protein in early stage of type 2 diabetic nephropathy and inflammatory cytokines.Methods A total of 90 patients with type 2 diabetes,including 60 with early stage diabetic nephropathy（DN） and 30 with initially diagnosed type 2 diabetes without proteinuria （DM）;another 30 normal subjects served as controls（NC）.The serum glucose,blood lipid,serum creatinine Scr and C-reactive protein（CRP） were measured by automatic biochemistry analyzer.The 24-hour urine protein was measured by dry-type chemical method.Urinary albumin excretory rate（UAER） was measured by radio-immunity method.Serum transforming growth factorβ1（TGF-β_1）,interleukin（IL）-6,tumor necrosis factor-α（TNF-α）,and 1L-18 were measured by enzyme linked immunosorbent assay（ELISA） method.Results①The serum levels of CRP,TGF-β_1,IL-6,TNF-α,and IL-18 in DM and DN groups were significantly higher than those in the control group （P0.05,0.01）,and there were also significant differences between DN and DM groups.②Correlation analysis showed that the serum TGF-β1（r = 0.285）,CRP（r = 0.317）,TNF-α（r = 0.658）,IL-6（r = 0.556）,IL-18（r = 0.392）,24 h urine protein（r = 0.514）,ALB/Cr（r = 0.691） and disease course（r = 0.806） in all the type 2 diabetes patients（DM and DN groups） were positively correlated with UAER（P0.05,0.01）.Liner regression relation showed that the change of UAER was associated with the course of disease,24-hour urine protein and TNF-α： UAER=（-12.132）＋（0.449） disease course ＋（0.692） TNF-α＋（78.971） 24 h urine protein.Conclusion Some inflammatory cytokines are increased in patients with type 2 diabetes or the early stage diabetic nephropathy.Inflammation participates in the development and progression of diabetic nephropathy.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第11期1035-1038,共4页
Shanghai Medical Journal
基金
常州市社会发展指导性项目资助项目(C82006907)
关键词
糖尿病
糖尿病肾病
炎性因子
尿白蛋白排泄率
Diabetes
Diabetic nephropathy
Inflammatory cytokine
Urinary albumin excretory rate
