文章摘要
聂礼强,臧建华,周立新,彭 辽,买买提明·喀迪尔,翟 云.2型糖尿病肾病患者血清GDF-15、sVCAM-1、YKL-40、α-klotho蛋白水平与糖脂代谢、胰岛素抵抗及肾功能的相关性分析[J].,2021,(14):2703-2707
2型糖尿病肾病患者血清GDF-15、sVCAM-1、YKL-40、α-klotho蛋白水平与糖脂代谢、胰岛素抵抗及肾功能的相关性分析
Correlation Analysis of Serum GDF-15, sVCAM-1, YKL-40, α-klotho Protein Levels with Glucose and Lipid Metabolism, Insulin Resistance and Renal Function in Patients with Type 2 Diabetic Nephropathy
投稿时间:2021-01-06  修订日期:2021-01-28
DOI:10.13241/j.cnki.pmb.2021.14.022
中文关键词: 型糖尿病肾病  可溶性血管细胞黏附分子-1  生长分化因子 - 15  α-klotho蛋白  几丁质酶3样蛋白1  糖脂代谢  胰岛素抵抗  肾功能
英文关键词: Type 2 diabetic nephropathy  Soluble vascular cell adhesion molecule-1  Growth differentiation factor-15  α-klotho protein  Chitinase 3-like protein 1  Glucose and lipid metabolism  Insulin resistance  Renal function
基金项目:新疆维吾尔自治区自然科学基金项目(201301DC439)
作者单位E-mail
聂礼强 中国人民解放军陆军第九四七医院血液内分泌科 新疆 疏勒 844200 ks947yy@163.com 
臧建华 中国人民解放军新疆军区总医院影像科 新疆 乌鲁木齐 830000  
周立新 中国人民解放军陆军第九四七医院血液内分泌科 新疆 疏勒 844200  
彭 辽 中国人民解放军陆军第九四七医院检验病理输血科 新疆 疏勒 844200  
买买提明·喀迪尔 中国人民解放军陆军第九四七医院血液内分泌科 新疆 疏勒 844200  
翟 云 中国人民解放军陆军第九四七医院血液内分泌科 新疆 疏勒 844200  
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中文摘要:
      摘要 目的:探讨2型糖尿病(T2DM)肾病患者血清可溶性血管细胞黏附分子-1(sVCAM-1)、生长分化因子 - 15(GDF-15)、α-klotho蛋白、几丁质酶3样蛋白1(YKL-40)水平与糖脂代谢、胰岛素抵抗及肾功能的关系。方法:选取2017年2月~2020年5月期间我院收治的T2DM患者80例,将T2DM患者根据有无糖尿病肾病分为T2DM无肾病组(n=43)、T2DM肾病组(n=37)。并选取同期于我院体检的健康志愿者50例作为对照组。检测所有受试者的血脂指标:总胆固醇(TC)、高密度脂蛋白(HDL)、甘油三酯(TG)、低密度脂蛋白(LDL),肾功能指标:尿素氮(BUN)、肌酐(Scr),血糖指标:糖化血红蛋白(HbA1c)、空腹血糖(FPG),胰岛素抵抗指标:稳态模型-胰岛素抵抗指数(HOMA-IR),GDF-15、sVCAM-1、α-klotho蛋白、YKL-40水平。分析血清GDF-15、sVCAM-1、YKL-40、α-klotho蛋白水平与血糖指标、血脂指标、胰岛素抵抗指标 、肾功能指标的相关性。结果:T2DM肾病组GDF-15、sVCAM-1、YKL-40较对照组、T2DM无肾病组高(P<0.05),T2DM肾病组α-klotho蛋白低于T2DM无肾病组、对照组(P<0.05)。T2DM肾病组、T2DM无肾病组TC、TG、LDL、BUN、HOMA-IR、Scr、FPG、HbA1c水平较对照组高,且T2DM肾病组高于T2DM无肾病组(P<0.05),T2DM肾病组、T2DM无肾病组HDL水平低于对照组,且T2DM肾病组低于T2DM无肾病组(P<0.05)。Pearson相关性分析结果显示,GDF-15、sVCAM-1、YKL-40与TC、TG、LDL、BUN、Scr、FPG、HbA1c、HOMA-IR均呈正相关,而与HDL呈负相关(P<0.05),α-klotho蛋白与TC、TG、LDL、BUN、Scr、FPG、HbA1c、HOMA-IR均呈负相关,而与HDL呈正相关(P<0.05)。结论:GDF-15、sVCAM-1、YKL-40、α-klotho蛋白在T2DM肾病患者血清中异常表达,可能参与该疾病的发生、发展。
英文摘要:
      ABSTRACT Objective: To investigate the relationship between serum soluble vascular cell adhesion molecule-1 (sVCAM-1), growth differentiation factor-15 (GDF-15), α-klotho protein, chitinase 3-like protein 1 (YKL-40) and glucose and lipid metabolism, insulin resistance and renal function in patients with type 2 diabetic (T2DM) nephropathy. Methods: 80 patients with T2DM in our hospital from February 2017 to May 2020 were selected, they were divided into T2DM without nephropathy group (n=43) and T2DM nephropathy group (n=37) according to the presence or absence of diabetic nephropathy. 50 healthy volunteers in our hospital during the same period were selected as the control group. Blood lipid indexes: total cholesterol (TC), high density lipoprotein (HDL), triglyceride (TG), low density lipoprotein (LDL), renal function indexes: urea nitrogen (BUN), creatinine (SCR), blood glucose indexes: glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), insulin resistance indexes: homeostasis model insulin resistance index (HOMA-IR), GDF-15, sVCAM-1, α-klotho protein, YKL-40 levels were detected. The correlation of serum GDF-15, sVCAM-1, YKL-40, α-klotho protein levels with blood glucose, blood lipid, insulin resistance and renal function were analyzed. Results: GDF-15, sVCAM-1 and YKL-40 in T2DM nephropathy group were higher than those in control group and T2DM without nephropathy group (P<0.05). α- Klotho protein in T2DM nephropathy group was lower than that in T2DM without nephropathy group and control group (P<0.05). The serum levels of sVCAM-1, GDF-15 and YKL-40 in T2DM without nephropathy group and T2DM nephropathy group were higher than those in control group, and the T2DM nephropathy group was higher than that in T2DM without nephropathy group (P<0.05). The levels of TC, TG, LDL, BUN, HOMA-IR, Scr, FPG and HbA1c in T2DM nephropathy group and T2DM without nephropathy group were higher than those in control group, and the T2DM nephropathy group was higher than that in T2DM without nephropathy group (P<0.05). The levels of HDL in T2DM nephropathy group and T2DM without nephropathy group were lower than those in control group, and the T2DM nephropathy group was lower than that in T2DM without nephropathy group (P<0.05). Pearson correlation analysis showed that GDF-15, sVCAM-1 and YKL-40 were positively correlated with TC, TG, LDL, BUN, Scr, FPG, HbA1c and HOMA-IR, but negatively correlated with HDL(P<0.05). α - Klotho protein was negatively correlated with TC, TG, LDL, BUN, Scr, FPG, HbA1c and HOMA-IR, but positively correlated with HDL (P<0.05). Conclusion: The abnormal expression of GDF-15, sVCAM-1, YKL-40 and α-klotho proteins in the serum of patients with T2DM nephropathy may be involved in the occurrence and development of the disease.
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