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目的探讨糖尿病肾病(DN)患者血清抵抗素水平及与胰岛素抵抗(IR)的关系。方法 63例T2DM患者随机分为3组:依据尿微量蛋白排泄率分为A组正常白蛋白尿组(UAER<30mg/24h)20例,B组微量白蛋白尿组(30mg/24h≤UAER<300mg/24h)22例,C组临床蛋白尿组(UAER≥300mg/24h)21例。D组为健康体检的正常对照组,共21例。分别检测各组的血清抵抗素、空腹血糖(FPG)、空腹胰岛素(Fins)及胰岛素抵抗指数(Homa-IR)、低密度脂蛋白(LDL-C)、内生肌酐清除率(Ccr),分析血清抵抗素水平与各检测指标的相关性。结果与正常对照组(D组)比较,A、B、C组的血清抵抗素、UAER、LDL-C、HbAlc、Homa-IR均明显升高(P均<0.05),而Ccr显著降低(P<0.05)。B组、C组与A组比较,血清抵抗素、UAER、LDL-C、HbAlc、Homa-IR的水平均显著升高(P均<0.05),而Ccr显著降低(P<0.05)。相关分析显示,DM组中,Resistin与Homa-IR、UAER、LDL-C、HbA1c均呈显著正相关(P<0.05),与Ccr呈负相关(P<0.05)。结论血清抵抗素与DN患者的胰岛素抵抗密切相关,检测T2DM患者的血清抵抗素变化,在一定程度上可反映其肾脏病变。
Objective To investigate the relationship between serum resistin and insulin resistance (IR) in patients with diabetic nephropathy (DN). Methods Sixty-three patients with T2DM were randomly divided into three groups: 20 cases of normal albuminuria group (UAER <30mg / 24h), microalbuminuria group (30mg / 24h≤UAER < Twenty-two patients (300mg / 24h) and 21 patients with clinical albuminuria (UAER≥300mg / 24h). Group D is a normal control group of healthy physical examination, a total of 21 cases. The levels of serum resistin, fasting blood glucose (FPG), fasting insulin (Fins), Homa-IR, LDL-C and Ccr in each group were determined. Serum resistin levels and the detection of the correlation between indicators. Results Compared with normal control group (D group), serum resistin, UAER, LDL-C, HbAlc and Homa-IR of group A, B and C were significantly increased (P < <0.05). The levels of serum resistin, UAER, LDL-C, HbAlc and Homa-IR in group B and group C were significantly higher than those in group A (P <0.05), while Ccr was significantly lower (P <0.05). Correlation analysis showed that there was a significant positive correlation between Resistin and Homa-IR, UAER, LDL-C and HbA1c in DM group (P <0.05), but negatively correlated with Ccr (P <0.05). Conclusions Serum resistin is closely related to insulin resistance in DN patients. Detecting the change of serum resistin in T2DM patients may reflect the renal disease.