摘要
目的观察糖尿病肾病(DKD)患者血清孤啡肽(N/OFQ)、白细胞介素-6(IL-6)水平变化及其相关性。方法选择2021年3月至2022年3月确诊的2型糖尿病(T2DM)患者180例,根据尿白蛋白/肌酐比值(ACR)分为正常白蛋白尿组(ACR<30 mg/g)、微量白蛋白尿组(30 mg/g≤ACR≤300 mg/g)和大量白蛋白尿组(ACR>300 mg/g),每组60例。记录3组的一般资料及相关并发症情况,监测空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿微量白蛋白(mALB)、尿白蛋白/肌酐比值(ACR)、估算肾小球滤过率(eGFR)、总胆固醇(CHO)、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)、中性粒细胞计数(NEUT)、中性粒细胞百分比(NEU%)。使用ELISA法测定3组血清N/OFQ、IL-6水平。分析上述指标并比较3组血清N/OFQ、IL-6水平的差异及其与DKD的相关性。采用logistic回归分析T2DM并发DKD的独立危险因素。采用受试者工作特征(ROC)曲线分析N/OFQ、IL-6单项及二者联合检测对DKD的预测价值。结果正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组合并糖尿病视网膜病变比例、糖尿病病程、FBG、HbA1c、mALB、ACR、NEU%、N/OFQ、IL-6水平逐渐升高(P<0.05),eGFR逐渐降低(P<0.05)。Pearson相关性分析结果显示,糖尿病病程、FBG、HbA1c、mALBs、ACR与血清N/OFQ、IL-6均呈正相关(P<0.05),eGFR与血清N/OFQ、IL-6均呈负相关(P<0.05),NEU%与血清N/OFQ呈正相关(P<0.05),而与IL-6无相关性(P=0.257);血清N/OFQ与IL-6水平呈正相关(P<0.001)。多因素Logistic回归分析结果显示,合并糖尿病视网膜病变、糖尿病病程、HbA1c、LDL-C、N/OFQ、IL-6是DKD疾病进展的危险因素(P<0.05)。ROC曲线分析结果显示,N/OFQ、IL-6、二者联合检测预测T2DM并发DKD的曲线下面积(AUC)分别为0.836、0.882、0.924,敏感度分别为0.855、0.848、0.913,特异度分别为0.679、0.762、0.674。结论血清N/OFQ、IL-6在DKD患者中高表达且具有一定相关性,二者升高�
Objective To observe the expression changes and correlations of serum nociceptin/orphanin FQ(N/OFQ)and interleukin-6(IL-6)in patients with diabetic kidney disease(DKD).Methods A total of 180 patients with type 2 diabetes mellitus(T2DM)diagnosed in Second Hospital of Shanxi Medical University from March 2021 to March 2022 were selected.According to the urine albumin/creatinine ratio(ACR),they were allocated to the normal buminuria group(ACR<30mg/g),microalbuminuria group(30mg/g≤ACR≤300mg/g)and macroalbuminuria group(ACR>300mg/g),with 60 cases in each group.Baseline characteristics and related complications of each group were recorded.Fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary microalbumin(mALB),albumin to creatinine ratio(ACR),estimate glomerular filtration rate(eGFR),total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),neutrophils(NEUT),and neutrophil percentage(NEUT%)were measured.Serum FQ(N/OFQ),and Interleukin 6(IL-6)levels in each group were measured by ELISA.The above indexes were analyzed and the differences in serum N/OFQ and IL-6 levels in three groups and their correlations with DKD were compared.Logistic regression was used to analyze the independent risk factors for DKD.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of N/OFQ,IL-6,or their combination in diagnosing DKD.Results The incidence of diabetic retinopathy,duration of diabetes,FBG,HbA1c,mALB,ACR,NEU%,N/OFQ,and IL-6 levels gradually increased in normal albuminuria group,microalbuminuria group,and macroalbuminuria group,while eGFR gradually decreased(all P<0.05).Pearson correlation analysis showed that the duration of diabetes,FBG,HbA1C,mALB and ACR were positively correlated with serum N/OFQ and IL-6,and eGFR was negatively correlated with serum N/OFQ and IL-6(all P<0.05).NEU%was positively correlated with serum N/OFQ(P<0.05),but not correlated with IL-6(P=0.257).Serum N/OFQ was positively correlated with I
作者
柴丹
韩毅
侯文飞
CHAI Dan;HAN Yi;HOU Wenfei(Shanxi Medical University Anesthesia College,Shanxi,Taiyuan 030012,China;不详)
出处
《河北医药》
CAS
2023年第8期1125-1130,1136,共7页
Hebei Medical Journal
基金
国家自然科学基金资助项目(编号:81400260)
山西省基础研究计划(编号:20210302123267)。
