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目的 探讨 2型糖尿病患者血清及尿Ⅳ型胶原 (Ⅳ C)的变化及其与糖尿病肾病 (DN)的关系和意义。方法 采用放射免疫法检测 10 3例 2型糖尿病患者及 33例健康人血清和尿Ⅳ C水平。结果 2型糖尿病患者血清Ⅳ C水平 [(75 .5 3± 2 3.4 2 ) μg/L]、尿Ⅳ C水平 [(2 7.71± 13.31) μg/L]均明显高于正常对照组 [(38.83± 6 .75 ) μg/L、(9.0 1± 3.4 3) μg/L](P均 <0 .0 1) ;糖尿病各亚组血清Ⅳ C、尿Ⅳ C水平均高于正常对照组 (P均 <0 .0 1) ,且各亚组间差异显著 ,两者均随 2 4h尿白蛋白排泄率 (UAER)的增加和糖尿病病程的延长而递增 ;糖尿病患者血清Ⅳ C水平与尿素氮、血 β2 微球蛋白 (β2 MG)、UAER均呈显著正相关 ;尿Ⅳ C水平与尿素氮、血肌酐、血β2 MG、尿 β2 MG、UAER均呈显著正相关 ;两者与病程、空腹血糖 (FBG)、糖化血红蛋白 (HbA1c)均高度相关。结论 2型糖尿病患者存在胶原代谢异常 ,血清及尿Ⅳ C水平随DN的严重程度而明显增高 ,两者均可作为早期预测和监测DN的敏感指标
Objective To investigate the changes of serum and urinary type Ⅳ collagen (Ⅳ C) and its relationship with diabetic nephropathy (DN) in type 2 diabetic patients. Methods Radioimmunoassay was used to detect serum and urinary C levels in 103 type 2 diabetic patients and 33 healthy controls. Results The serum level of IV C was (75.53 ± 2 3.4 2) μg / L] and the level of urine IV C was (2.771 ± 13.31) μg / L in patients with type 2 diabetes mellitus (38.83 (P <0.01). The levels of serum IV C and urine C C in all subgroups of diabetic patients were significantly higher than those in normal controls (P <0.05) All <0.01), and there was significant difference between the two subgroups. Both of them increased with the increase of urinary albumin excretion rate (UAER) at 24 hours and duration of diabetes mellitus. The serum level of IV C in diabetic patients was significantly correlated with urea nitrogen, There was a significant positive correlation between blood urea nitrogen, serum creatinine, blood β2 MG, urinary β2 MG and UAER, both of which were positively correlated with the duration of disease, fasting blood glucose (FBG), glycated hemoglobin (HbA1c) were highly correlated. Conclusions Collagen metabolism is abnormal in patients with type 2 diabetes mellitus, serum and urinary levels of IV C are significantly increased with the severity of DN, both of which may be used as sensitive indicators for early prediction and monitoring of DN