摘要
目的探讨2型糖尿病肾病（DN）患者血清25羟基维生素D[25-（OH）D]和C-反应蛋白（CRP）变化及临床意义。方法选择2型糖尿病（T2DM）患者148例，体检健康者50例，依据尿清蛋白／肌酐比值（UACR）将T2DM患者分为正常清蛋白（Alb）尿组（UACR〈30mg／gcr）、微量Alb尿组（UACR30—299mg／gcT）和大量Alb尿组（UACR≥300mg／gcr）。用电化学发光法检测血清25-（OH）D，免疫散射比浊法检测CRP，同时检测患者相关生化指标，分析25-（OH）D与CRP及其他实验指标的相关性。结果正常Alb尿组、微量Alb尿组和大量Alb尿组血清25-（OH）D依次降低（P〈0．01），微量Alb尿组和大量Alb尿组血清25-（OH）D较正常Alb尿组和健康人对照组降低（P〈0．01）。正常Alb尿组、微量Alb尿组和大量Alb尿组血清CRP依次升高，较健康人对照组差异均有统计学意义（P均〈0．01）。血清25-（OH）D随病程增加而降低（P〈0．01）；而CRP有增高趋势，但差异无统计学意义（P〉0．05）。血清25-（OH）D与CRP、肌酐（Cr）、尿酸（uA）、磷（P5＋）及UACR呈负相关（r分别为-0．396、-0．198、-0．179、-0．228、-0．793，P均〈0．05），与肾小球滤过率（eGFR）呈正相关（r=0．281，P〈0．01）。结论血清25-（OH）D降低与DN患者肾损伤程度相关，可能参与DN发生与发展。
Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D [25-（OH） D] and C-reactive protein i CRP） in the patients with type 2 diabetic nephropathy （DN）. Methods A total of 148 T2DM patients were included and 50 healthy individuals as controls. According to urinary albumin to creatinine ratios （UACR）, the ＇patients were divided into 3 groups： the normal albuminuria group （ UACR 〈 30 mg/g Cr）, the microalbuminuria group （ UACR 30 to 299 mg/g Cr） and the massive proteinu- ria group （ UACR~〉300 mg/g Cr）. The levels of serum 25-（OH） D were measured by electrochemiluminescence and CRP levels were measured by immuno-scatter turbidimetry. The relevant biochemical parameters were measured simultaneously. The correlations be- tween serum 25-（OH） D or CRP and other laboratory parameters were analyzed. Results The level of serum 25-（OH） D in the 3 groups decreased successively （P 〈0.01 ）. The levels of serum 25-（OH） D in the microalbuminuria and massive proteinuria group were significantly lower than those in the normal albuminuria group and healthy control （P 〈 0.01 ）. The serum CRP levels in the 3 groups increased successively and showed significant difference from the control （P 〈 0.01 ）. The levels of serum 25-（OH） D de- creased and CRP increased with the duration of diabetes course, but no significant differences were found （ P 〉 0.05 ）. The levels of serum 25-（OH）D were negatively coirelated with CRP, creatinine, uric acid, phosphorus in serum and UACR （r = -0. 396, - 0.198, - 0.179, - O. 228 and - 0.793, P 〈 0.05 ）, while the serum 25- （OH） D was positively correlated with estimated glomerular filtration rate （eGFR） （ r = O. 281, P 〈 O. 01 ）. Conclusion The reduction of 25-（OH） D in serum should be related to the severity of kidney damage in DN patients and may play a role in the development and progression of DN.
出处
《临床检验杂志》
CAS
CSCD
北大核心
2013年第11期838-840,843,共4页
Chinese Journal of Clinical Laboratory Science
