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目的 探讨血清对氧磷酯酶 1(PON1)活性与 2型糖尿病 (DM)并发肾病 (DN)的关系。方法 血清PON1活性用酚乙酸酯为底物测定 ,血浆氧化型低密度脂蛋白 (ox LDL)用ELISA法测定 ,尿 2 4小时微量白蛋白用放免法测定。结果 91例 2型DM患者的PON1活性比 5 4例正常对照显著降低〔(138.2± 31.4 )kU/Lvs (184 .1± 2 9.5 )kU/L ,P <0 .0 0 1〕 ,且 2型DM的Ⅰ组 (UAER <30mg/ 2 4h)、Ⅱ组 (UAER 30～ 30 0mg/ 2 4h)和Ⅲ组 (UAER >30 0mg/ 2 4h)相比 ,PON1活性依次显著下降〔(15 1.8± 2 4 .5 )kU/L ,(12 4 .5± 32 .8)kU/L ,(10 1.1± 36 .6 )kU/L ,P <0 .0 1〕 ,而ox LDL的浓度却依次显著升高〔(6 16 .2± 135 .7) μg/L ,(75 3.9± 132 .5 ) μg/L ,(875 .1± 15 3.2 ) μg/L ,P <0 .0 1〕。PON1活性与ox LDL的浓度呈高度负相关 (r =- 0 .83,P <0 .0 0 1) ,也与UAER呈负相关 (r =- 0 .2 8,P<0 .0 5 ) ,多元回归分析表明PON1活性是 2型DM并发DN的高度危险因素 (P <0 .0 1)。结论 PON1活性在 2型DM显著下降 ,且在并发DN的 2型DM患者下降更显著。PON1活性与ox LDL呈负相关。PON1活性降低是 2型DM并发DN的高度危险因素
Objective To investigate the relationship between serum paraoxonase 1 (PON1) activity and type 2 diabetic nephropathy (DN). Methods The serum PON1 activity was measured by using phenol acetate as substrate, the level of oxidized low density lipoprotein (ox LDL) was measured by ELISA, and the urine 24 h microalbumin was determined by radioimmunoassay. Results The PON1 activity of 91 patients with type 2 DM was significantly lower than that of 54 normal controls [(138.2 ± 31.4) kU / L vs (184.1 ± 2 9.5) kU / L, P <0.01) (P <0.05), the activity of PON1 decreased significantly in group I (UAER <30 mg / 24 h), group II (UAER 30-30 0 mg / 24 h) and group III (UAER> 30 0 mg / 24 h) ± 2 4 .5) kU / L, (12 4.5 ± 32.8) kU / L, (10 1.1 ± 36.6) kU / L, P <0.01) (6 16.2 ± 135.7) μg / L, (75 3.9 ± 132.5) μg / L, (875.1 ± 15 3.2) μg / L, P <0.01, respectively) . PON1 activity was negatively correlated with oxLDL concentration (r = - 0.83, P <0.001) and also with UAER (r = - 0.28, P <0.05) Multiple regression analysis showed that PON1 activity was a high risk factor for type 2 DM complicated with DN (P <0.01). Conclusions PON1 activity is significantly decreased in type 2 DM, and is more pronounced in type 2 DM with DN. PON1 activity was negatively correlated with ox LDL. Decreased PON1 activity is a high risk factor for type 2 DM complicated with DN