2型糖尿病血清同型半胱氨酸、视黄醇结合蛋白与尿微量白蛋白/肌酐比值的相关性分析

常丽; 黄莹芝

doi:10.13898/j.cnki.issn.1000-2200.2023.10.015

2型糖尿病血清同型半胱氨酸、视黄醇结合蛋白与尿微量白蛋白/肌酐比值的相关性分析

常丽,
黄莹芝

Correlation analysis of the serum levels of homocysteine, retinol binding protein and urine microalbumin-creatinine ratio in patients with type 2 diabetes mellitus

摘要

摘要:
目的探讨2型糖尿病病人血清中同型半胱氨酸(homocysteine, Hcy)、视黄醇结合蛋白(retinol binding protein，RBP)与尿微量白蛋白/肌酐比值(urine microalbumin-creatinine ratio，ACR)的关系。
方法根据尿ACR将490例糖尿病病人分为3组，其中378例为正常白蛋白尿组(NA组，ACR < 30 mg/g)，71例为微量白蛋白尿组(MA组，ACR为30~300 mg/g)，41例为大量白蛋白尿组(LA组，ACR>300 mg/g)。所有研究对象均测量身高、体质量，计算体质量指数(BMI)，并检测尿素(BUN)、肌酐(Cr)、Hcy、RBP、尿ACR、胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、空腹血糖(FPG)和糖化血红蛋白(HbA1c), 并分析3组血清Hcy、RBP、Cr、BUN与尿ACR的相关性。
结果3组间年龄、BMI、HbA1C、FPG、TG差异均无统计学意义(P>0.05)。病程和LDL水平，NA组低于MA组和LA组，MA组低于LA组；HDL水平，NA组高于MA组和LA组，MA组高于LA组；TC水平，LA组高于MA、NA组，差异均有统计学意义(P < 0.05~P < 0.01)；LA组血清Hcy、RBP、Cr、BUN水平较MA、NA组均升高，MA组RBP、Hcy、Cr、BUN水平较NA组升高，差异均有统计学意义(P < 0.01)；病人血清Cr、BUN、Hcy和RBP水平与尿ACR水平均呈正相关关系(P < 0.01)。
结论血清Hcy、RBP能反映糖尿病早期肾损伤，与尿ACR呈正相关关系，血清RBP敏感性更高，两者对2型糖尿病肾病的早期诊断有重要的价值。

Abstract:
ObjectiveTo explore the relationship between the serum levels of homocysteine(Hcy), retinol binding protein(RBP) and urine microalbumin-creatinine ratio(ACR) in patients with type 2 diabetes mellitus.
MethodsAccording to the urine ACR, 490 diabetic patients were divided into the normal albuminuria group(NA group, 378 cases with ACR < 30 mg/g), microalbuminuria group(MA group, 71 cases with ACR 30-300 mg/g) and large amount of albumin group(LA group, 41 cases with ACR >300 mg/g).The height, weight and body mass index(BMI) in all cases were measured, the serum levels of blood urea nitrogen(BUN), creatinine(Cr), Hcy, RBP, ACR, total cholesterol(TC), triglycerides(TG), low-density lipoprotein(LDL), high-density lipoprotein(HDL), fasting plasma glucose(FPG) and glycosylated hemoglobin(HbA1c) in three groups were examined, and the correlation between the serum levels of Hcy, RBP, Cr, BUN and ACR among three groups were analyzed.
ResultsThere was no statistical significance in the age, BMI, HbA1C, FPG and TG among three groups(P>0.05).The course of disease and LDL level in NA group was lower than those in MA group and LA group, and which in MA group was lower than that in LA group; the level of HDL in NA group was higher than that in MA group and LA group, and which in MA group was higher than that in LA group; the TC level in LA group was higher than that in MA group and NA group(P < 0.05 to P < 0.01).The serum levels of Hcy, RBP, Cr and BUN in LA group increased compared with MA group and NA group, the serum levels of RBP, Hcy, Cr and BUN in MA group increased compared with the NA group, and the differences of which were statistically significant(P < 0.01).The serum levels of Cr, BUN, Hcy and RBP in patients were positively correlated with the urinary ACR level(P < 0.01).
ConclusionsThe serum levels of Hcy and RBP can reflect the early diabetic kidney injury, and are positively correlated with urinary ACR, the serum RBP sensitivity is higher, and both of which have important value for early diagnosis of type 2 diabetic nephropathy.

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