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目的探讨血清脂联素(APN)与2型糖尿病(T2DM)肾病的相关性。方法 90例T2DM和30例健康查体者为研究对象,90例T2DM患者根据24 h尿白蛋白水平分为三组:A组:正常蛋白尿组(24 h尿蛋白排泄量(uAlb)<30 mg);B组:微量白蛋白尿组(24 h uAlb 30~300 mg);C组:大量白蛋白尿组(24 h uAlb>300 mg)。测定血清APN水平、uAlb、血肌酐(Scr)水平,常规检测血脂水平。结果 T2DM组血清APN水平与对照组比较显著下降(P<0.05),uAlb、TG、Scr与对照组比较显著上升(P<0.05);血清APNu、Alb、Scr水平为A组B组>C组,三组间比较差异有统计学意义(P<0.05);T2DM患者血清APN水平与uAlb、Scr水平呈显著正相关(r=0.637、0.431,P<0.05),与TG水平呈显著负相关(r=-0.312,P<0.05)。结论 T2DM肾病患者血清APN水平随着uAlb、Scr水平的升高而升高,且与脂代谢显著相关。血清APN水平的升高可能预示着糖尿病微血管病变的进展与肾功能的减退。
Objective To investigate the relationship between serum adiponectin (APN) and type 2 diabetes mellitus (T2DM) nephropathy. Methods Totally 90 T2DM patients and 30 healthy subjects were enrolled in this study. 90 T2DM patients were divided into three groups based on 24-hour urinary albumin levels: group A: normal proteinuria group (24 h urinary protein excretion <30 group B: microalbuminuria group (30 ~ 300 mg 24 h uAlb); group C: large albuminuria group (24 h uAlb> 300 mg). Serum APN levels, uAlb, serum creatinine (Scr) levels were measured, and serum lipid levels were routinely measured. Results Serum APN level in T2DM group was significantly lower than that in control group (P <0.05), while uAlb, TG and Scr were significantly increased compared with control group (P <0.05). Serum APNu, Alb and Scr levels were lower in group A than in group B (P <0.05). The levels of serum TG were A group> B group> C group, the difference was statistically significant between the three groups (P <0.05). The level of serum APN in T2DM patients (R = 0.637,0.431, P <0.05), but negatively correlated with the level of TG (r = -0.312, P <0.05). Conclusion The level of serum APN in patients with T2DM nephropathy increases with the increase of uAlb and Scr, and is significantly correlated with lipid metabolism. Elevated serum levels of APN may indicate the progression of diabetic microangiopathy and renal dysfunction.