摘要
目的:探讨血清Irisin、Betatrophin水平与2型糖尿病肾病的相关性。方法:选取2016年9月~2017年9月我院治疗的2型糖尿病患者90例,依据尿微量白蛋白与肌酐比值(ACR)评价肾脏情况,分为正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组,每组各30例;另选取同期我院30例健康体检者为正常对照组。测量各组身高、体重、腰围、臀围、腹围等体测指标,计算体质量指数(BMI)和腰臀比(WHR)。检测各组血清Irisin、Betatrophin、总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FBG)、空腹胰岛素(FINS)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)等生化指标,计算稳态模型胰岛素抵抗指数(HOMA-IR)值,并分析Irisin、Betatropnin与BMI、WHR、FBG、FINS、TC、TG、Scr、BUN、UA等的相关性。结果:随着ACR增加,2型糖尿病患者的血清Irisin水平逐渐下降(P <0. 05),Betatrophin水平逐渐增加(P <0. 05)。糖尿病合并异常白蛋白尿患者血清Irisin水平与BMI、WHR、Hb A1c、TG、BUN、Scr、ACR呈负相关(P <0. 05),与HDL-C呈正相关(P <0. 05)。Betatrophin与WHR、Hb A1c、HOMA-IR、LDL-C、Scr、ACR呈正相关(P <0. 05),与其他指标均无明显相关性(P <0. 05)。多元线性回归分析结果显示,Irisin水平的主要影响因素为Hb A1c、TG、ACR、BUN(P <0. 05); Betatrophin影响因素主要有WHR、LDL-C、ACR、Scr(P <0. 05)。结论:血清Irisin、Betatrophin水平与DN的严重程度相关,可能参与了DN的发病过程。
Objective:To explore the relationship between serum irisin,betatrophin level and renal function in patients with type 2 diabetes.Methods:A total of 90 cases of patients with type 2 diabetes that presented during the period of Sept 2016 to Sept 2017 were selected and divided into the Normal albuminuria(n=30),Microalbuminuria(n=30)and Macroalbuminuria(n=30)groups according to the ratio of urine microalbuminuria to creatinine(ACR),and in the same period,there were 30 healthy persons in our hospital were selected as the normal control group.The subjects were followed general physical examination,such as height,weight,waistline,hipline and so on,then body mass index(BMI)and waist-hip ratio(WHR)was calculated.Irisin,betatrophin,triglycerides(TG),fasting blood glucose(FBG),fasting insulin(FINS),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),urea nitrogen(BUN),uric acid(UA)were also measured and homeostasis model assessment of insulin resistance(HOMA-IR)were evaluated in all subjects,and then analyse the correlation between irisin,betatropnin and BMI,WHR,FBG,FINS,TC,TG,Scr,BUN,UA and so on.Results:With the increase of ACR,the level of serum irisin in patients with type 2 diabetes decreased gradually and the level of betatrophin increased(P<0.05).The level of serum irisin in patients with diabetic nephropathy was negatively correlated with BMI,WHR,HbA1c,TG,BUN,Scr,ACR(P<0.05),and was positively related to HDL-C(P<0.05).It showed positive correlation between the level of betatrophin and WHR,HbA1c,HOMA-IR,LDL-C,Scr,ACR(P<0.05).The results of multivariate linear regression analysis revealed that the main factors affecting the irisin level were HbA1c,TG,ACR,and BUN,while WHR,LDL-C,ACR and Scr were the main influencing factors to betatrophin(P<0.05).Conclusion:The level of irisin and betatrophin are associated with the severity of DN,which may be involved in the pathogenesis of DN.
作者
刘师伟
段瑞雪
吴亚茹
汪湄湄
薛雪花
LIU Shiwei;DUAN Ruixue;WU Yaru(Department of Endocrinology,Shanxi DAYI Hospital,Taiyuan(030032))
出处
《中国中西医结合肾病杂志》
2018年第10期861-865,共5页
Chinese Journal of Integrated Traditional and Western Nephrology
基金
国家自然科学基金资助项目(No.81471025)
山西省回国留学人员科研基金资助项目(No.2015-109)
山西省科技成果转化引导专项项目(No.201604D131003)
山西省留学回国人员科技活动择优资助重点项目(No.2017)
白求恩.默克糖尿病研究基金资助项目(No.G2017044)
山西省科技攻关项目(No.20140313014-5)
