摘要
目的分析胰岛素样生长因子-1(IGF-1)与糖尿病肾病(DN)关系及IGF-1对DN临床作用机制影响。方法选取2014年1月至2017年8月接受治疗的2型糖尿病(T2DM)患者110例,依据患者尿蛋白排泄率(UAER)水平及Mogensen提出DN诊断准则将患者分成3组,单纯T2DM(SDM)组32例,早期DN(EDN)组30例和临床DN(CDN)组48例,同时选取同期进行体检健康者50例为对照组,采集4组对象早晨空腹静脉血6 ml,酶联免疫吸附法(ELISA)检测血清IGF-1水平,酶比色法检测血清肌酐(SCr)水平,葡萄糖氧化酶法检测空腹血糖(FPG)和餐后2 h血糖(2hPG)水平,动力学紫外法检测血清尿素氮(BUN)水平,免疫抑制比浊法检测血清糖化血红蛋白(HbA1c)水平,反射免疫法检测血清C肽水平,电化学发光法检测尿白蛋白水平。结果对照组、SDM、EDN及CDN组患者血清IGF-1水平分别为(144.19±35.14)ng/ml、(184.62±36.07)ng/ml、(224.58±35.70)ng/ml、(285.28±35.83)ng/ml,C肽水平分别为(3.24±0.35)ng/ml、(1.79±0.38)ng/ml、(1.24±0.33)ng/ml、(0.90±0.31)ng/ml,4组间对比差异均有统计学意义(P<0.05),CDN组2hPG水平高于对照组,差异有统计学意义(P<0.05);对照组、SDM、EDN及CDN组患者血清SCr水平分别为(94.02±8.17)mol/L、(99.68±8.24)mol/L、(104.19±8.20)mol/L、(137.47±8.60)mol/L,HbA1c分别为(4.75±0.59)%、(7.30±0.62)%、(7.05±0.58)%、(7.11±0.61)%,BUN水平分别为(5.29±1.02)mmol/L、(5.95±1.07)mmol/L、(6.79±1.14)mmol/L、(8.46±1.20)mmol/L,UAER水平分别为(7.38±2.14)μg/min、(13.02±2.68)μg/min、(162.46±2.79)μg/min、(346.25±2.95)μg/min,4组间对比差异均有统计学意义(均P<0.05);Pearson相关分析显示,UAER和IGF-1水平为正相关关系(r=16.024,P<0.05),UAER和HbA1c、FPG及2hPG没有相关性(r=0.524、1.085、1.752,P>0.05)。结论 DN患者血清内IGF-1水平和其疾病程度有紧密联系,可作为糖尿病患者并发糖尿病肾病前期预测指标。
Objective To analyze the relationship between insulin-like growth factor-1(IGF-1)and diabetic nephropathy(DN)and the effects of IGF-1 on the action mechanism in DN,in order to provide some references for clinical diagnosis and treatment.Methods A total of 110 patients with T2 DM who were treated in our hospital from January 2014 to August 2017 were enrolled in the study.According to the urinary protein excretion rate(UAER)content and the DN diagnosis criteria proposed by Mogensen,these patients were divided into three groups:simple DM group(SDM group,n=32),early DN group(EDN group,n=30)and clinical DN group(CDN,group,n=48),at the same time,50 healthy subjects who underwent physical examination in our hospital were enrolled as control group.The serum levels of IGF-1 were detected by ELISA,serum creatinine(SCr)levels were determined by enzyme colorimetry,and the levels of fasting plasma glucose(FPG)and postprandial 2-hour plasma glucose(2 hPG)were measured by glucose oxidase method,and serum urea levels were detected by kinetic UV method.Moreover the/content of nitrogen(BUN)was detected by immunoturbidimetric turbidimetry,and the content of serum glycosylated hemoglobin(HbA1 c)was measured by immunoreactive turbidimetric method,and the serum levels of serum C peptide were measured by reflex immunoassay.The levels of urinary albumin were measured by electrochemiluminescence.Results The serum levels of IGF-1 were(144.19±35.14)ng/ml,(184.62±36.07)ng/ml,(224.58±35.70)ng/ml,(285.28±35.83)ng/ml in control group,SDM group,EDN group and CDN group,respectively,and C peptide levels were(3.24±0.35)ng/ml,(1.79±0.38)ng/ml,(1.24±0.33)ng/ml,(0.90±0.31)ng/ml,respectively,there were significance differences among the four groups(P<0.05).The 2 hPG levels in CDN group were(12.58±0.65)mmol/L,which were significanly higher than those[(8.64±0.67)mmol/L]in control group(P<0.05).The serum levels of SCr were(94.02±8.17)mol/L,(99.68±8.24)mol/L,(104.19±8.20)mol/L,(137.47±8.60)mol/L in control group,SDM group,EDN group,CDN group
作者
张文川
ZHANG Wenchuan(Department of Urology,People’s Hospital of Dongguan City,Guangdong,Dongguan 523000,China)
出处
《河北医药》
CAS
2019年第6期910-912,916,共4页
Hebei Medical Journal
