2型糖尿病患者分泌型卷曲相关蛋白5水平和胰岛素抵抗与尿白蛋白的关系

摘要

目的：分析2型糖尿病（T2DM）患者分泌型卷曲相关蛋白5（SFRP5）水平和胰岛素抵抗（IR）与尿白蛋白的关系。方法：137例T2DM 住院患者，根据尿白蛋白排泄率（UAER）分为三组：正常白蛋白尿组（DM1组， n＝47）；微量白蛋白尿组（DM2组，n＝45）；大量蛋白尿组（DM3组，n＝45）。另选同期体检健康者作为对照组（NC组，n＝50）。采用ELISE检测各组血清SFRP5、葡萄糖氧化酶法测定空腹血糖（FBG）、电化学发光免疫分析法测定空腹胰岛素（FINS），计算稳态胰岛素抵抗指数（HOMA‐IR）。比较组间差异并分析其相关性。结果：与 NC组比较，T2DM各组 HOMA‐IR、FINS、FBG和UAER均升高（P＜0．05或 P＜0．01），以DM3组升高最明显（P＜0．05或 P＜0．01）；DM1组SFRP5水平显著低于NC组（P＜0．01），但DM2组、DM3组则较DM1组升高，以DM3组升高最明显（P＜0．01）。相关性分析显示，T2DM 患者 SFRP5与 HOMA‐IR呈正相关（r＝0．507，P＜0．01），且SFRP5和HOMA‐IR与UAER亦成正相关（r＝0．791、0．345，P＜0．01）。结论：SFRP5可能与IR共同参与糖尿病肾病（DN ）的发生发展，或可成为DN诊疗的新靶点。%Objective:To investigate the correlation of secreted frizzled‐related protein 5(SFRP5) level and in‐sulin resistance with albuminuria in type 2 diabetes(T2DM ) .Method:A total of 137 patients with T2DM were en‐rolled .According to urinary albumin excretion rate ,the patients with T2DM were divided into three groups :normoal‐buminurial group(DM1 group ,n=47) ,microalbuminuria group(DM2 group ,n=45) ,macroalbuminuria group(DM3 group ,n=45) .The control group included 50 healthy individuals(NC group) .Serum SFRP5 level was detected with ELISA method .Fasting blood glucose(FBG) was measured by gautose oxidase method .Fasting insulin(FINS) was measured by electrochemical iuminescence .Insulin resistance (HOMA‐IR) was applied by homeostasis model assess‐ment .To compare the differences of index among groups .Results:Compared with NC group ,HOMA‐IR ,FINS , FBG and UAER in DM1 group ,DM2 group ,DM3 group were increased ,especially DM3 group was increased most obviously (P<0 .05 or P<0 .01) .SFRP5 in DM1 group was significantly lower than NC group (P<0 .01) ,but it in the DM2 group and DM3 group were higher than DM1 group ,especially DM3 group was increased most obviously (P<0 .01) .Correlation analysis showed that SFRP5 level was positive correlated with HOMA‐IR(r=0 .507 ,P<0 . 01) .SFRP5 and HOMA‐IR ,respectively ,correlate with UAER(r=0 .791 ,0 .345 ,P<0 .01) .Conclusion:SFRP5 and IR maybe involved in the occurrence and development of diabetic nephropathy (DN ) ,and may become the new target for diagnosis and treatment of DN .