血清脂蛋白(a)与糖尿病肾病早期肾损害的关系

摘要

目的 探讨血清脂蛋白a[Lp(a)]与糖尿病肾病(DN)早期肾损害的关系.方法 选择2015年5月至2016年12月期间榆林市第一医院内分泌科收治的163例2型糖尿病(T2DM)患者为研究对象,88例尿白蛋白排泄率(UAER)<30 mg/24 h纳入DM组,75例UAER在30～300 mg/24 h者纳入早期DN组,并选择70例健康体检者纳入对照组.检测比较三组受检者的血肌酐(Scr)、尿素氮(BUN)及血清Lp(a)水平.结果 DM组患者的血清Lp(a)为(146.57±40.31)mg/L,明显高于对照组的(80.47±34.25)mg/L,差异有统计学意义(P<0.05);早期DN组患者的UAER、血清Lp(a)水平分别为(146.87±38.58)mg/24 h、(191.76±54.55)mg/L,明显高于DM组的(18.58±8.64)mg/24 h、(146.57±40.31)mg/L,差异均有统计学意义(P<0.05);Pearson相关分析结果显示,早期DN组患者血清Lp(a)水平与UAER呈正相关性(r=0.553,P<0.05).结论 血清Lp(a)水平有效反映早期DN肾损害,T2DM患者定期检测血清Lp(a)水平可以早期识别DN.%Objective To investigate the relationship between serum lipoprotein Lp(a) and early renal dam-age in patients with diabetic nephropathy (DN). Methods A total of 163 patients with type 2 diabetes mellitus (T2DM) who admitted in Department of Endocrinology in Yulin First Hospital from May 2015 to December 2016 were selected as the research objects, including 88 patients with urinary albumin excretion rate (UAER)<30 mg/24 h (DM group) and 75 patients with UAER of 30-300 mg/24 h (early DN group). Seventy healthy people were enrolled into the control group. The levels of serum creatinine (Scr), urea nitrogen (BUN) and serum Lp(a) were compared among the three groups. Results The serum Lp(a) in DM group was (146.57 ± 40.31) mg/L, which was significantly higher than (80.47±34.25) mg/L in the control group (P<0.05);The serum UAER, Lp(a) levels in early DN group were respec-tively (146.87 ± 38.58) mg/24 h, (191.76 ± 54.55) mg/L, which were significantly higher than (18.58 ± 8.64) mg/24 h, (146.57 ± 40.31) mg/L in DM group (P<0.05); Pearson correlation analysis showed that the serum Lp(a) level of pa-tients in early DN group was positively correlated with UAER (r=0.553, P<0.05). Conclusion Serum Lp(a) level can effectively reflect the early renal damage of DN. For patients with T2DM, regular detection of serum Lp(a) level can help early identify DN.