超敏C反应蛋白和同型半胱氨酸与早期糖尿病肾病的相关性研究

摘要

目的 探讨血清超敏C反应蛋白(hs-CRP)和同型半胱氨酸(Hcy)水平与早期糖尿病肾病的相关性.方法 选取2010-2012年在本院内分泌科就诊、并被初次诊断为2型糖尿病的患者91例,根据尿清蛋白排泄率(UAER)分为单纯糖尿病组(48例)和早期糖尿病肾病组(43组),测定两组患者血清hs-CRP和Hcy水平.并采用Pearson法分析hs-CRP、Hcy水平与UAER的关系;采用Logistic回归分析早期2型糖尿病肾病的危险因素.结果 (1)早期糖尿病肾病组患者血清hs-CRP和Hcy水平均高于单纯糖尿病组[hs-CRP:(2.6±1.4)mg/L与(1.4±1.1)mg/L;Hcy:(32.7±7.7)μmol/L与(19.3±4.9)μmol/L],两组比较差异有统计学意义(P＜0.01).(2)Pearson相关分析显示,hs-CRP、Hcy水平均与UAER呈正相关(r值分别为0.535和0.758,P均＜0.01),且Hcy与hs-CRP亦呈正相关(r=0.411,P＜0.01).(3)Logistic回归分析显示,HbA1c、hs-CRP和Hcy水平升高均是糖尿病患者早期肾脏损害的独立危险因素(β值分别为0.568、0.807和0.064,P值分别为0.019、0.013和0.000).结论 hs-CRP和Hcy水平升高可能是2型糖尿病患者早期肾脏损害的重要危险因素之一.%Objective To investigate the relationship between the level of serum high sensitivity C reactive protein ( hs - CRP ), serum homocysteine ( Hcy ) and early stage diabetic nephropathy ( DN ) .Methods Ninety one patients diagnosed as type 2 diabetes mellitus at the first time in department of endocrinology of our hospital from 2010 to 2012 were enrolled, and were divided into diabetes mellitus group ( 48 cases ) and early DN group ( 43 cases ) according to urine albumin urinary albumin excretion rate ( UAER ) .Serum hs - CRP and serum Hcy were measured.Relationship between hs - CRP, Hcy and UAER were analyzed by Pearson correlation.Logistic regression was used to analyze risk factor of early stage type 2 DN.Results ( 1 ) Levels of hs - CRP and Hcy in early DN group were higher than those in diabetes mellitus group [ hs - CRP: ( 2.6 ± 1.4 ) mg/L vs.( 1.4 ± 1.1 ) mg/L; Hcy: ( 32.7 ±7.7 ) μmol/L vs.( 19.3 ±4.9 ) μmol/L; P <0.01 ] .( 2 ) Pearson correlation analysis showed that levels of hs - CRP and Hcy had positive relation with UAER ( r =0.535 , 0.758 ; P <0.01 ) .Hcy had positive relation with hs - CRP too ( r = 0.411 , P < 0.01 ) .( 3 ) Logistic regression revealed that the levels of HbA1c, hs - CRP and Hcy were independently correlated with the risk of early damage of kidney (β= 0.568 , 0.807 , 0.064; P = 0.019 , 0.013 , 0.000 ) .Conclusion Elevated levels of hs - CRP or Hcy might be an important risk factor for early renal damage of patients with type 2 diabetes.