摘要
目的检测2型糖尿病(T2DM)合并慢性肾脏病(CKD)患者的脂肪细胞型脂肪酸结合蛋白(A-FABP水平,并探讨其临床意义。方法连续性选取2018年8月至2019年7月间南方医科大学深圳医院收治的220例T2DM合并CKD患者作为观察组,根据尿白蛋白/尿肌酐比值(UACR)分组,其中UACR<30 mg/g者70例(A组),300 mg/g>UACR≥30 mg/g者82例(B组),UACR≥300 mg/g者68例(C组)。以同期门诊体检正常者54例作为对照组。采用酶联免疫吸附法测定受试者血浆中的A-FABP水平,比较各组受试者的临床指标[体重指数(BMI)、空腹血糖(FPG)、餐后2 h血糖PBG、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、甘油三脂(TG)、胆固醇(TC)、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)],分析A-FABP水平与上述相关指标的关系。结果观察组患者的BMI、FPG、2 hPBG、HbA1c、FINS、HOMA-IR、LDL-C、TG、TC、Scr及A-FABP水平明显高于对照组,HOMA-β、HDL-C水平明显低于对照组,差异均具有统计学意义(P<0.05);A、B、C三组之间FPG、2 hPBG、HbA1c、TG、HDL-C、LDL-C水平比较,差异均无统计学意义(P>0.05);A、B、C三组患者的HOMA-IR、A-FABP水平均呈增高趋势,HOMA-β呈降低趋势,两两比较差异均具有统计学意义(P<0.05);C组患者的TC水平为(4.12±1.30) mmol/L,明显高于A组的(3.48±0.29) mmol/L,差异具有统计学意义(P<0.05),但B组的TC水平分别与A、C组比较,差异均无统计学意义(P>0.05);C组患者的Scr水平为(111.67±33.09)μmol/L,明显高于A组的(87.72±5.70)μmol/L和B组的(87.57±8.79)μmol/L,差异均具有统计学意义(P<0.05),但A组和B组间的Scr水平比较差异无统计学意义(P>0.05);Pearson相关分析结果显示A-FABP与BMI、FPG、2 hPBG、HbA1c、FINS、HOMA-IR、HOMA-β、TC、HDL-C均呈正相关(r=0.315、0.237、0.332、0.533、0.318、0.741、0.725、0.263、0.275,P<0.05);多因素Logistic回归�
Objective To investigate the levels of adipocyte fatty acid binding protein(A-FABP) in patients with type 2 diabetes mellitus(T2 DM) and chronic kidney disease(CKD), and its clinical significance. Methods A total of 220 T2 DM patients with CKD admitted to Shenzhen Hospital of Southern Medical University from August 2018 to July2019 were selected as the observation group, and according to urinary albumin/urinary creatinine ratio(UACR), the patients were divided into three groups: 70 patients with UACR <30 mg/g(group A), 83 patients with 300 mg/g> UACR≥30 mg/g(group B), and 68 patients with UACR≥300 mg/g(group C). Fifty-four healthy subjects visited for physical examination were selected as the control group. The levels of A-FABP in the plasma of the subjects were measured by enzymelinked immunosorbent assay. The clinical indexes, including body mass index(BMI), fasting blood glucose(FPG), postprandial 2 h blood glucose(PBG), glycosylated hemoglobin(Hb A1 c), fasting plasma insulin(FINS), insulin resistance index(HOMA-IR), islet beta cell function index(HOMA-β), triglyceride(TG), cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), serum creatinine(Scr) were compared. The relationship between A-FABP levels and the above-mentioned related indicators was analyzed. Results The levels of BMI, FPG,2 h PBG, Hb A1 c, FINS, HOMA-IR, LDL-C, TG, TC, Scr, and A-FABP in the observation group were significantly higher than those in the control group, and the levels of HOMA-β and HDL-C were lower than those in the control group(P<0.05). There were no significant differences in the levels of FPG, 2 hPBG, HbA1 c, TG, HDL-C, and LDL-C among the three groups(P>0.05). The HOMA-IR and A-FABP levels of patients in group A, B, and C showed an increasing trend,and HOMA-β showed a decreasing trend, with significant differences between each two groups(P<0.05). The TC level of group C was(4.12±1.30) mmol/L, which was significantly higher than(3.48±0.29) mmol/L of group A(P<0.05);
作者
陈泽衍
陈晓静
兰希
聂赫中容
郑文斌
刘欣桐
吴云风
郭伟权
马雯
CHEN Ze-yan;CHEN Xiao-jing;LAN Xi;NIEHE Zhong-rong;ZHENG Wen-bin;LIU Xin-tong;WU Yun-feng;GUO Wei-quan;MA Wen(Department of Clinical Laboratory,Shenzhen Hospital of Southern Medical University,Shenzhen 518110,Guangdong,CHINA;Department of Clinical Laboratory,General Hospital of Shenzhen University,Shenzhen 518055,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第4期429-433,共5页
Hainan Medical Journal
基金
广东省自然科学基金(编号：2018A0303130119、2018030310063)
广东省深圳市卫计委临床技术研究及转化项目(编号：201601040)
关键词
2型糖尿病
脂肪细胞型脂肪酸结合蛋白
胰岛素抵抗
慢性肾脏病
血脂
Type 2 diabetes mellitus
Adipocyte-type fatty acid binding protein
Insulin resistance
Chronic kidney disease
Blood lipids
