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目的目前关于血清betatrophin水平与糖尿病肾病(DN)的研究较少,文中旨在观察新诊断2型糖尿病(T2DM)患者血清betatrophin水平,探讨其与尿白蛋白肌酐比(UACR)的关系。方法选取2013年3月至2016年7月在江苏大学附属医院内分泌代谢科新诊断T2DM就诊患者90例,以及同期在体检中心体检的健康者60例(对照组),患者90例按UACR水平分为2组:UACR正常组(UACR<30 mg/g,n=60)、UACR异常组(UACR>30 mg/g,n=30)。采用酶联免疫吸附法测定血清betatrophin水平,采用免疫比浊法测定UACR,同时检测血糖、血脂等指标。结果 UACR异常组的betatrophin明显高于UACR正常组[(677.37±59.02)pg/m L vs(486.13±41.22)pg/m L,P<0.05]。T2DM患者血清betatrophin水平与年龄(r=0.246)、腰臀比(r=0.240)、空腹血糖(r=0.234)、餐后2 h血糖(r=0.363)、糖化血红蛋白(Hb A1c)(r=0.346)、空腹胰岛素(r=0.249)、胰岛素抵抗指数(HOMA-IR)(r=0.309)、血尿素氮(r=0.223)、血肌酐(r=0.277)及UACR(r=0.244)呈正相关(P<0.05),与肾小球滤过率(r=0.308)呈负相关(P<0.01);UACR正常组血清betatrophin与年龄、Hb A1c、UACR呈正相关(P<0.05);UACR异常组血清betatrophin与腰臀比(r=0.504)、餐后2 h血糖(r=0.600)、Hb A1c(r=0.449)、HOMA-IR(r=0.395)呈正相关(P<0.05)。肾小球滤过率、HOMA-IR、Hb A1c及腰臀比是血清betatrophin水平的影响因素。结论 T2DM合并蛋白尿患者的血清betatrophin水平的显著提高提示,betatrophin可能参与了DN的发生发展。
Objective There are few studies on the serum betatrophin levels and diabetic nephropathy (DN). The purpose of this study was to observe the serum betatrophin levels in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and to explore its relationship with urinary albumin creatinine ratio (UACR). Methods From March 2013 to July 2016, 90 patients with newly diagnosed T2DM in the Department of Endocrinology and Metabolism of Affiliated Hospital of Jiangsu University and 60 healthy people (control group) were enrolled in the physical examination center during the same period. 90 patients were divided into UACR There were 2 groups: UACR normal group (UACR <30 mg / g, n = 60) and UACR abnormal group (UACR> 30 mg / g, n = 30). Serum betatrophin levels were measured by enzyme-linked immunosorbent assay (ELISA), UACR was measured by immunoturbidimetry, and blood glucose, blood lipid and other indicators were detected. Results The level of betatrophin in UACR abnormal group was significantly higher than that in UACR normal group [(677.37 ± 59.02) pg / m L vs (486.13 ± 41.22) pg / m L, P <0.05]. Serum levels of betatrophin in patients with T2DM were significantly lower than those in patients with age (r = 0.246), waist-to-hip ratio (r = 0.240), fasting plasma glucose (r = 0.234), postprandial 2h blood glucose (r = 0.363), Hb A1c 0.346), fasting insulin (r = 0.249), insulin resistance index (r = 0.309), blood urea nitrogen (r = 0.223), serum creatinine (r = 0.277) and UACR (r = 0.244) (P <0.05), but negatively correlated with glomerular filtration rate (r = 0.308) (P <0.01). Serum betatrophin was positively correlated with age, Hb A1c and UACR in the normal UACR group (P <0.05) Serum betatrophin was positively correlated with HOMA-IR (r = 0.395), waist-hip ratio (r = 0.504), postprandial blood glucose at 2 hours (r = 0.600), Hb A1c (r = 0.449) Glomerular filtration rate, HOMA-IR, Hb A1c and waist-to-hip ratio were the influencing factors of serum betatrophin levels. Conclusion The significant increase of serum betatrophin level in T2DM patients with proteinuria suggests that betatrophin may be involved in the development of DN.