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目的探讨2型糖尿病(T2DM)患者血清分泌型卷曲相关蛋白5(SFRP-5)水平与糖尿病肾病(DN)的相关性。方法选择T2DM住院患者137例,根据尿白蛋白排泄率(UAER)分为3组:正常白蛋白尿组(A组)47例;微量白蛋白尿组(B组)45例;大量白蛋白尿组(C组)45例。选择50例健康体检者作为对照组。ELISA法检测血清SFRP-5,同时测定空腹静脉血糖(FBG)、血脂、肝肾功能、UAER。比较各组间的指标差异。结果 4组SFRP-5比较差异均有统计学意义(P<0.05)。T2DM患者血清SFRP-5的水平低于对照组,B组、C组血清SFRP-5水平高于A组,C组血清SFRP-5水平高于B组(均P<0.05)。血清SFRP-5水平与舒张压(DBP)、总胆固醇(CHO)、甘油三酯(TG)、FBG、空腹血清胰岛素(Fins)、胰岛素抵抗指数(HOMA-IR)、尿素氮(BUN)、肌酐(CR)、UAER呈正相关,与高密度脂蛋白(HDL)、肾小球滤过率(GFR)、总胆红素呈负相关。多元线性回归分析显示,UAER、HOMA-IR、空腹血糖(FBG)、空腹血糖(FBG)、尿酸(UA)、收缩压(SBP)、TG是SFRP-5的独立影响因素。结论T2DM患者血清SFRP-5水平随着UAER的增加而升高,两者可能参与糖尿病肾病的发生,并可能成为糖尿病肾病发生及发展过程中的新的标记物。
Objective To investigate the relationship between serum secreted Frizzled Related Protein 5 (SFRP-5) and diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM). Methods Thirty-seven patients with T2DM were selected and divided into three groups according to urinary albumin excretion rate (UAER): 47 cases of normal albuminuria (group A), 45 cases of microalbuminuria (group B) Group (C group) 45 cases. Select 50 cases of healthy people as a control group. Serum SFRP-5 was detected by ELISA, fasting venous blood glucose (FBG), blood lipid, liver and kidney function, UAER were measured. Compare the differences between the indicators of each group. Results There were significant differences in SFRP-5 between the four groups (P <0.05). The serum level of SFRP-5 in T2DM patients was lower than that in control group. The serum SFRP-5 levels in patients in group B and C were higher than those in patients in group A, while the level of SFRP-5 in patients with T2DM was higher than that in group B (all P <0.05). Serum SFRP-5 levels were positively correlated with DBP, CHO, TG, FBG, Fins, HOMA-IR, BUN and creatinine (CR) and UAER, but negatively correlated with high density lipoprotein (HDL), glomerular filtration rate (GFR) and total bilirubin. Multiple linear regression analysis showed that UAER, HOMA-IR, fasting blood glucose (FBG), fasting blood glucose (FBG), uric acid (UA), systolic blood pressure (SBP) and TG were the independent influencing factors of SFRP-5. Conclusion The level of SFRP-5 in T2DM patients increases with the increase of UAER, both of which may be involved in the development of diabetic nephropathy and may be new markers in the occurrence and development of diabetic nephropathy.