目的 检测2型糖尿病(T2DM)患者血清几丁质酶3样蛋白1(YKL-40/CHI3L1)浓度、尿白蛋白/肌酐比值(UACR),探讨T2DM患者血清YKL-40/CHI3L1与白蛋白尿的相关性.方法 共纳入T2DM患者187例,其中正常范围白蛋白尿组(UACR＜30 mg·g-1)58例,微量白蛋白尿组(UACR 30～300 mg· g-1)66例,大量白蛋白尿组(UACR＞ 300 mg·g-1) 63例,正常对照组为同期健康个体25例.收集所有研究对象人口学指标、临床及实验室数据,检测其血清YKL-40/CHI3L1及UACR.结果 正常对照组、正常范围白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组YKL-40/CHI3L1中位数分别为39、70、89、126 μg·L-1,各组间两两比较差异均有统计学意义(P＜0.05).单因素相关分析显示,YKL-40/CHI3L1与UACR呈正相关(r=0.27,P ＜0.001);采用多元回归模型对相关协变量进行校正后显示,YKL-40/CHI3L1仍与UACR独立相关(β=0.25,P＜0.001).结论 YKL-40/CHI3L1可能与T2DM肾病的发生发展有关,而进行YKL-40/CHI3L1、UACR联合检测可能有助于预测T2DM慢性血管并发症的发生.%Objective To detect the serum chitinase-3-like protein 1 (YKL-40/CHI3L1) concentration and the ratio of urinary albumin and creatinine (UACR) ,and to observe the relationship of YKL-40/CHI3L1 and albuminuria in patients with type 2 diabetes mellitus(T2DM). Methods One hundred and eighty-seven patients with T2DM were enrolled in this study;58 cases in normoalbuminuria group ( UACR < 30 mg · g -1),66 cases in microalbuminuria group ( UACR 30 - 300 mg · g-1) , and 63 cases in macroalbuminuria group (UACR > 300 mg · g-1 ). Twenty-five healthy individuals were chosen as control group. The basic demographic characteristics, clinical and laboratory data of the patients were collected, and the serum levels of YKL40/CHI3L1 and the UACR were detected. Results The median of the level of YKL-40/CHI3L1 in the control, normoalbuminuria, microalbuminuria and macroalbuminuria group was 39,70,89 and 126 μg · L-1 ,respectively;and there was significant difference among groups by pairwise comparisons ( P < 0. 05 ). Univariate analysis showed that YKL-40/CHI3L1 and UACR was positively correlated(r =0.27,P<0.001). After adjustment for significant covariates by multiple regression,YKL-40/CHI3L1 was still independently associated with UACR(β =0.25 ,P <0.001). Conclusion YKL40/CHI3L1 may be associated with the development of T2DM nephropathy, detection of the level of YKL-40/CHI3L1 and albuminuria may help to predict the chronic vascular complications in patients with T2DM.
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