摘要
目的探析沉默调节蛋白6(Sirt6)和脂质代谢指标在2型糖尿病肾病(T2DN)中的表达情况,分析其与肾功能指标的相关性及在T2DN预测中的效能。方法回顾性分析廊坊市人民医院2019年1月至2020年11月收治的160例2型糖尿病患者的资料,按有无肾病分为观察组(T2DN,80例)和对照组(普通2型糖尿病,80例)。采用qRT-PCR、酶联免疫分析法、全自动生化分析仪分别对Sirt6、脂质代谢指标[三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]、肾功能指标[血尿素氮(BUN)、血肌酐(Cr)]进行测定。比较两组的Sirt6、脂质代谢指标、肾功能指标的差异,Pearson法分析Sirt6、脂质代谢指标与肾功能指标的相关性,绘制受试者工作特征(ROC)曲线分析Sirt6、脂质代谢指标在T2DN诊断中的效能。结果观察组Sirt6 mRNA相对表达量低于对照组,TG、TC、LDL-C、BUN和Cr水平高于对照组(P<0.05)。Pearson相关性分析显示,Sirt6与BUN、Cr呈负相关(r=-0.802、-0.785,P<0.05);TG与BUN、Cr呈正相关(r=0.621、0.628,P<0.05);TC与BUN、Cr呈正相关(r=0.768、0.759,P<0.05);LDL-C与BUN、Cr呈正相关(r=0.722、0.718,P<0.05)。Sirt6、TG、TC、LDL-C诊断T2DN的ROC曲线下面积(AUC)分别为0.783、0.588、0.605和0.664,而四项联合的AUC(0.875)最高,灵敏度(92.50%)、特异度(93.75%)也最高。结论Sirt6在T2DN中低表达,与肾功能指标呈负相关;脂质代谢指标在T2DN中呈高水平,与肾功能指标呈正相关。在2型糖尿病患者中,若Sirt6值下降、脂质代谢指标水平上升,其肾损伤风险有升高趋势,可能存在肾功能障碍。
Objective To explore the expression of sirtuin 6(Sirt6)and lipid metabolism indicators in type 2 diabetic nephropathy(T2DN),and analyze their correlation with renal function indicators and their effectiveness in predicting T2DN.Methods The data of 160 patients with type 2 diabetes admitted to Langfang People's Hospital from January 2019 to November 2020 were retrospectively analyzed.The patients were divided into the observation group(n=80,T2DN)and the control group(n=80,merely type 2 diabetes)according to whether they had nephropathy or not.Sirt6,lipid metabolism indicators[triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)],and renal function indicators[blood urea nitrogen(BUN)and blood creatinine(Cr)]were measured by qRT-PCR,enzyme-linked immunosorbent assay and fully automated biochemical analyzer,respectively.The serum levels of Sirt6,lipid metabolism indicators and renal function indicators between the two groups were compared,the correlation between Sirt6,lipid metabolism indicators,and renal function indicators was analyzed by Pearson correlation.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of Sirt6,lipid metabolism indicators in the diagnosis of T2DN.Results The relative expression level of Sirt6 mRNA in the observation group was lower than that in the control group,and the levels of TG,TC,LDL-C,BUN and Cr were higher than those in the control group(P<0.05).Pearson correlation analysis showed that Sirt6 was negatively correlated with BUN(r=-0802,P<0.05)and Cr(r=-0.785,P<0.05);TG was positively correlated with BUN(r=0.621,P<0.05)and Cr(r=0.628,P<0.05);TC was positively correlated with BUN(r=0.768,P<0.05)and Cr(r=0.759,P<0.05);LDL-C was positively correlated with BUN(r=0.722,P<0.05)and Cr(r=0.718,P<0.05).The area under the ROC curve(AUC)of Sirt6,TG,TC and LDL-C for diagnosis of T2DN was 0.783,0.588,0.605 and 0.664,respectively,while the AUC(0.875),sensitivity(92.50%),and specificity(93.75%)of combination of the four indexes were the highest.Conclusion Sirt6 is low expressed in T2DN and negatively correlated with renal function indicators.The lipid metabolism indicators are highly expressed in T2DN and positively correlated with renal function indicators.If the Sirt6 value decreases and the levels of lipid metabolism indicators increase in patients with type 2 diabetes,it reflects that the risk of renal impairment has an increscsing trend,which might lead to renal dysfunction.
作者
夏彩霞
姜晓文
房京州
段冬梅
蔡明镜
杨志霞
张宏颖
XIA Caixia;JIANG Xiaowen;FANG Jingzhou;DUAN Dongmei;CAI Mingjing;YANG Zhixia;ZHANG Hongying(Endocrinology Department,Langfang People's Hospital,Langfang,Hebei 065000,China)
出处
《中国临床研究》
CAS
2023年第12期1816-1820,共5页
Chinese Journal of Clinical Research
基金
廊坊市科学技术研究与发展计划项目(2020013110)。
