摘要
目的观察不同时期糖尿病肾脏病（DKD）患者血清8-羟基脱氧鸟苷（8-OHdG）水平的变化,并探讨其与DKD的相关性。方法选择2014年5月—2015年10月河北医科大学第三医院内分泌一科住院的2型糖尿病患者228例（T2DM组）,入选同期健康体检者80例作为健康对照组（NC组）,T2DM组患者根据尿微量白蛋白/肌酐（尿A/Cr）水平分为SDM亚组（单纯T2DM）80例、mic-DKD亚组（微量白蛋白尿）70例和mac-DKD亚组（大量白蛋白尿）78例。采用ELISA测定各组对象的血清8-OHdG水平,分析其与空腹血糖（FPG）、糖化血红蛋白（HbA_（1c））、胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、血肌酐（SCr）、尿素氮（BUN）、血尿酸（UA）、尿A/Cr等指标的相关性,并分析DKD发生的危险因素。结果 （1）T2DM组血清8-OHdG浓度高于NC组[（7.20±2.37）ng/mlvs.（3.94±0.26）ng/ml,t=20.418,P〈0.01];亚组之间比较：mac-DKD亚组血清8-0HdG浓度为（9.68±1.17）ng/ml,高于mic-DKD组的（7.34±1.32）ng/ml及SDM亚组的（4.65±0.74）ng/ml（t=11.365,t=32.206,P〈0.01）。（2）相关性分析：8-OHdG水平与尿A/Cr、TG、TC、FPG、HbA_（1c）、LDL-C、SCr及UA呈正相关（r值分别为0.818、0.745、0.669、0.662、0.661、0.639、0.339、0.242,P均〈0.01）,与HDL-C呈负相关（r=-0.628,P〈0.01）。（3）Logistic回归分析结果显示8-OHdG（OR=11.133,95%CI 3.359~36.895,P=0.000）、TG（OR=65.573,95%CI 4.400~977.265,P=0.030）、HbA_（1c）（OR=1.673,95%CI 1.019~2.744,P=0.042）、病程（0R=1.567,95%CI 1.182~2.077,P=0.002）和年龄（OR=1.106,95%CI 1.006~1.216,P=0.038）是DKD发生的独立危险因素。结论 8-OHdG水平可以反映DKD的严重程度,DKD发生发展与氧化应激有关。
Objective To observe the serum 8-hydroxy guanin（8-OHdG） level in different stage of type 2 diabetic kidney disease（DKD）patients and explore the correlation between 8-OHdG and DKD.Methods Eighty normal subjects（NC group） and 228 patients with type 2 diabetes（T2DM） were enrolled in this study.The T2 DM patients were all hospitalized from department of endocrinology,the third hospital of Hebei medical university since 2014 May to 2015 Oct.The T2 DM patients were further divided into three subgroups;simple type 2 diabetes mellitus（SDM） subgroup（n =80）,micro albuminuria（mic-DKD） subgroup（n =70） and macro albuminuria（mac-DKD） subgroup（n =78） according to the urinary albumin creatinine ratio.The level of serum 8-OHdG level in five groups was determined by enzyme linked immunosorbent assay（ELISA）.The correlation between 8-OHdG and FPG,HbA_（1c）,TC,TG,LDL-C,HDL-C,SCr,BUN,UA and urinary A/Cr were also analyzed.Logistic regression model was used to analyze the risk factors of DKD.Results（1） The serum 8-OHdG level in T2 DM group was（7.20 ±2.37）ng/ml,which was higher than the NC group（3.94 ±0.26） ng/ml（t =20.418,P 0.01）;Compared between subgroups：The serum 8-OHdG level in mac-DKD subgroup was（9.68 ±1.17）ng/ml,which was higher than the mic-DKD subgroup（7.34 ±1.32）ng/ml（t =11.365,P 0.01） and SDM subgroup（4.65 ±0.74） ng/ml（t =32.206,P 0.01）.（2）Correlation analysis;The serum 8-OHdG level was positively correlated with urinary A/Cr（r =0.818）,TG（r =0.745）,TC（r =0.669）,FPG（r =0.662）,HbA,,（r =0.661）,LDL-C（r =0.639）,SCr（r=0.339）and UA（r=0.242）（all P〈0.01）,negatively correlated with HDL-C（r=-0.628,P〈0.01）.（3） Logistic regression analysis showed that 8-OHdG（OR=11.133,95%CI 3.359-36.895,P=0.000）,TG（OR=65.573,95%CI 4.400-977.265,P=0.030）,HbA_（1c）（OR=1.673,95%CI 1.019-2.744,P=0.042）,duration（OR=1.567,95%CI1.182-2.077,P=0.002） and age（OR = 1.106,95%CI 1.006-1.216,P=0.038） were
出处
《疑难病杂志》
CAS
2016年第5期460-464,共5页
Chinese Journal of Difficult and Complicated Cases
