血清脂联素、抵抗素在2型糖尿病肾病中的水平分析

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[目的]探讨血清脂联素、抵抗素在2型糖尿病肾病(DN)发生、发展中的作用。[方法]选择糖尿病患者90例,根据尿微量白蛋白排泄率(UAER)分为单纯糖尿病组30例、早期DN组30例、临床DN组30例,同时取正常人30例为对照组。测定所有研究对象的血清脂联素、抵抗素水平,并分析其与UAER等指标的关系。[结果](1)正常人血清脂联素明显高于2型糖尿病患者(P﹤0.01),糖尿病患者中早期DN组的血清脂联素高于单纯糖尿病组(P﹤0.05),临床DN组的血清脂联素水平最高(P﹤0.01)。血清抵抗素水平在单纯糖尿病组、早期DN组及临床DN组中均明显高于健康对照组(P﹤0.05或P﹤0.01),且随病情进展逐渐升高。(2)在DN阶段,血清脂联素与抵抗素水平呈显著正相关,相关系数r=0.449(P﹤0.01);血清脂联素、抵抗素水平分别与UAER、血糖(BG)、血肌酐(Scr)、糖化血红蛋白(HbA1c)水平相关。(3)对糖尿病患者逐步回归分析显示,血清脂联素、抵抗素受UAER、HbA1c及Scr的影响较大。[结论脂联素、抵抗素与糖尿病肾病,发生、发展有关,检测其血清水平可能对早期诊断和评估DN有作用。脂联素、抵抗素有望成为治疗DN的新靶点。 [Objective] To explore the role of serum adiponectin and resistin in the occurrence and development of type 2 diabetic nephropathy (DN). [Methods] Ninety diabetic patients were selected. According to the urinary albumin excretion rate (UAER), they were divided into three groups: simple diabetic group (30 cases), early DN group (30 cases), clinical DN group (30 cases) and normal group (30 cases) as control group. Serum adiponectin and resistin levels were measured in all subjects and their association with UAER and other indicators was analyzed. [Results] (1) Serum adiponectin in normal people was significantly higher than that in type 2 diabetic patients (P <0.01). Serum adiponectin in DN patients in early DN group was higher than that in simple diabetic group (P <0.05) The highest level of serum adiponectin (P <0.01). Serum resistin levels were significantly higher in the diabetic group, the early DN group and the clinical DN group than those in the healthy control group (P <0.05 or P <0.01), and gradually increased with the progression of the disease. (2) There was a significant positive correlation between serum adiponectin and resistin level at DN stage (r = 0.449, P <0.01). Serum levels of adiponectin and resistin were positively correlated with UAER, BG and serum creatinine (Scr), glycated hemoglobin (HbA1c) levels. (3) Stepwise regression analysis of diabetic patients showed that serum adiponectin and resistin were greatly influenced by UAER, HbA1c and Scr. [Conclusions Adiponectin and resistin are related to diabetic nephropathy, occurrence and development, and detection of serum levels may have an effect on early diagnosis and assessment of DN. Adiponectin, resistin is expected to become a new target for the treatment of DN.
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