摘要
目的观察不同分期糖尿病肾脏病(diabetic kidney disease,DKD)患者血清趋化素(chemerin)及肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平的变化,并探讨其与DKD的相关性。方法入选45名健康体检者作为正常对照(normal control,NC)组和133例2型糖尿病患者,后者根据尿微量白蛋白/肌酐(the value of urinary albumin/creatine ratio,ACR)水平分为单纯糖尿病(simple diabetes mellitus,SDM)组47例、微量白蛋白尿(micro albuminuria DKD,mic-DKD)组41例和大量白蛋白尿(macro albuminuria DKD,mac-DKD)组45例。采用ELISA法测定4组研究对象的血清chemerin和TNF-α水平,并分析DKD发生的危险因素。结果 NC组血清chemerin浓度为(34.14±7.54)ng/ml,TNF-α浓度为(103.99±20.43)ng/L。SDM组血清chemerin浓度为(38.23±5.48)ng/ml,TNF-α浓度为(134.42±27.31)ng/L。mic-DKD组血清chemerin浓度为(42.69±8.os)ng/ml,TNF-α浓度为(165.48±32.63)ng/L。mac-DKD组血清chemerin浓度为(47.32±9.11)ng/ml,TNF-α浓度为(227.53±58.31)ng/L。4组血清chemerin和TNF-α水平逐渐升高,组间比较差异具有统计学意义(均P<0.05)。血清chemerin水平与TNF-α、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血肌酐(SCr)及病程呈正相关,与高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)呈负相关。血清TNF-α水平与尿ACR、HbA1c、hs-CRP、SCr、低密度脂蛋白胆固醇(ligh-density lipoprotein cholesterol,LDL-C)及病程呈正相关,与HDL-C呈负相关。Logistic回归分析显示,chemerin、TNF-α、白细胞、年龄、HbA1c、低HDL-C及高血压是DKD发生的独立危险因素。结论 Chemerin和TNF-α参与了DKD发病,检测其水平可以在一定程度上反映DKD病情的严重程度。
Objective To examine the level of serum chemerin and TNF-α in different stages of type 2 diabetic kidney disease （DKD） patients and explore the pathogenesis of DKD. Methods Forty- five normal subjects （NC group） and 133 patients with type 2 diabetes mellitus （T2DM） were enrolled in this study. The T2DM patients were divivded into three subgroups： simple T2DM （SDM） group （n = 47）, microalbuminuria （mic-DKD） group （n = 41） and macroalbuminuria （mac-DKD） group （n = 45） according to the urinary albumin creatinine ratio. The levels of serum chemerin and TNF-α were determined by ELISA. Logistic regession model was used to analyze the risk factors of DKD. Results Serum chemerin concentration and serum TNF-α concentration in NC group, SDM group, mic-DKD group and mac-DKD group were （34. 14 ± 7. 54）, （38. 23 ± 5. 48）, （42. 69 ± 8. 05） and （47. 32 ± 9. 11） ng/ml, and （103.99±20.43）,（134.42±27.31）, （165.48±32.63） and （227.53±58.31） ng/L, respectively. The levels of chemerin and TNF-α were increased gradually from NC group, SDM group, mic-DKD group to mac-DKD group with the difference being statistically significant between each two groups （all P〈0. 05）. The serum chemerin was positively correlative with TNF-α, hs-CRP, HbAlc, SCr and duration, but negatively correlated with FIDL-C. The serum TNF-α was positively correlated with urinary ACR, HbAlc, hs-CRP, SCr, LDL-C and duration, but negatively correlated with HDL-C. Logistic regression analysis revealed that chemerin, TNF-α, WBC, age, FIbAlc, lower FIDL-C and hypertension were independent risk factors of DKD. Conclusions Chemerin and TNF-α were involved in the pathogenesis of DKD, and their levels may reflect a degree of severity for DKD.
出处
《临床肾脏病杂志》
2016年第3期162-167,共6页
Journal Of Clinical Nephrology
关键词
趋化素
肿瘤坏死因子Α
超敏C反应蛋白
Chemerin
Tumor necrosis factor alpha
High sensitivity C-reactive protein
