摘要
目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)合并糖尿病肾病患者血清血管生成抑制蛋白1(vasohibin-1,VASH-1)浓度及其与尿白蛋白肌酐比值(urinary albumin to creatinine ratio,UACR)的相关性。方法回顾性分析大连大学附属新华医院2017年2月至2020年12月196例T2DM患者的临床资料,根据是否合并糖尿病肾病(diabetic nephropathy,DN)将患者分为病例组(T2DM合并DN,163例)和对照组(T2DM未合并DN,33例)。病例组再按不同UACR进一步分为正常组(Ⅰ组,UACR<30 mg/g,21例)、微量组(Ⅱ组,UACR≥30~≤300 mg/g,50例)、大量组(Ⅲ组,UACR>300 mg/g,43例)和大量并高血压组(Ⅳ组,UACR>300 mg/g且合并高血压,49例),检测各组患者血清VASH-1、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)、转化生长因子β1(transforming growth factorβ1,TGF-β1)以及其他血生化指标。符合正态分布的计量资料两组间比较采用t检验;多组间比较采用单因素方差分析,两两比较采用q检验。计数资料组间比较采用χ^(2)检验。T2DM合并DN影响因素分析采用多因素Logistic回归分析,VASH-1与UACR间相关性采用Pearson相关分析。结果病例组的UACR[(1175.9±120.4)mg/g]、CRP[(9.80±2.01)mg/L]、ESR[(20.61±2.20)mm/h]、TGF-β1[(16.75±2.05)μg/L]、VASH-1[(645.3±183.5)ng/L]高于对照组[(11.5±2.0)mg/g、(4.77±1.34)mg/L、(8.33±1.56)mm/h、(10.63±1.97)μg/L、(416.3±162.1)ng/L],差异均有统计学意义(t值分别为123.39、13.76、30.54、15.75、6.66,均P<0.001)。多因素Logistic回归分析结果显示,VASH-1(OR=1.881,95%CI 1.146~3.089)、UACR(OR=1.511,95%CI 1.064~2.146)、TGF-β1(OR=1.846,95%CI 1.135~3.001)均为T2DM合并DN的影响因素(P值分别为0.009、0.022、0.012)。Ⅲ组及Ⅳ组患者血清VASH-1[(693.5±201.4)、(709.8±214.7)ng/L]均高于Ⅰ组、Ⅱ组[(585.3±162.1)、(632.9±165.5)ng/L],组间比较差异有统计学意义(F=129.46,P<0.001)。Ⅰ组、Ⅱ组、Ⅲ组及Ⅳ组患者CRP[(7.08�
Objective To investigate the correlation between serum concentration of vasohibin-1(VASH-1)and urinary albumin creatinine ratio(UACR)in patients with type 2 diabetes mellitus(T2DM)and diabetic nephropathy.Methods The clinical data of 196 patients with T2DM from February 2017 to December 2020 were analyzed retrospectively.According to whether diabetic nephropathy(DN)was combined,33 patients without DN of T2DM were divided into the control group,and 163 patients with DN of T2DM were divided into the case group,and the case group was divided into four groups:normal albuminuria group(groupⅠ,UACR<30 mg/g,21 cases),microalbuminuria group(groupⅡ,UACR≥30-≤300 mg/g,50 cases),clinical albuminuria group(groupⅢ,UACR>300 mg/g,43 cases),and clinical albuminuria hypertensive group(groupⅣ,UACR>300 mg/g with hypertension,49 cases).Serum levels of VASH-1,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and transforming growth factorβ1(TGF-β1)with other biochemical indicators were measured.T-test was used for comparison between measurement data groups in accordance with normal distribution,one-way ANOVA was used for comparison between multiple groups,q-test was used for pairwise comparison,andχ^(2) test was used for comparison between counting data groups.The influencing factors were analyzed by multivariate Logistic regression.Pearson correlation analysis was used to analyze the correlation between vash-1 and UACR.Results UACR((1175.9±120.4)mg/g),CRP((9.80±2.01)mg/L),ESR((20.61±2.20)mm/h),TGF-β1((16.75±2.05)μg/L),VASH-1((645.3±183.5)ng/L)in case group were higher than that in the control group((11.5±2.0)mg/g,(4.77±1.34)mg/L,(8.33±1.56)mm/h,(10.63±1.97)μg/L,(416.3±162.1)ng/L),and there were significant differences between the two groups(t=123.39,13.76,30.54,15.75,6.66;all P<0.001).Multivariate logistic regression analysis showed that VASH-1(OR=1.881,95%CI 1.146-3.089),UACR(OR=1.511,95%CI 1.064-2.146),TGF-β1(OR=1.846,95%CI 1.135-3.001)were all risk factors for DN of T2DM(P values were 0.009,0.0
作者
王智峰
李秋梅
姜啸
徐心悦
Wang Zhifeng;Li Qiumei;Jiang Xiao;Xu Xinyue(Department of Endocrinology,Xinhua Hospital Affiliated to Dalian University,Dalian 116021,China)
出处
《中国综合临床》
2022年第3期268-273,共6页
Clinical Medicine of China
