血清25-羟维生素D3、脂蛋白相关磷脂酶A2与早期糖尿病肾病的相关性研究

doi:10.3969/j.issn.1004-583X.2019.10.010

临床荟萃

血清25-羟维生素D3、脂蛋白相关磷脂酶A2与早期糖尿病肾病的相关性研究

上海市第一康复医院内分泌代谢与肾脏康复科, 上海 200090

出版日期:2019-10-20 发布日期:2019-12-09
通讯作者: 董萍, Email: dongping809@163.com

Correlation analysis on serum level of 25hydroxy vitamin D3 and lipoproteinassociated phospholipase A2 with early diabetic nephropathy

Department of Endocrinology, First Rehabilitation Hospital of Shanghai, Shanghai 200090, China

Online:2019-10-20 Published:2019-12-09
Contact: Corresponding author: Dong Ping, Email: dongping809@163.com

摘要/Abstract

摘要： 目的探讨早期糖尿病肾病(diabetic nephropathy, DN)患者血清25羟维生素D3［25(OH)D3］、脂蛋白相关磷脂酶A2(LPPLA2)水平，分析其与早期DN的相关性。方法选取入住我院内分泌科的2型糖尿病(T2DM)患者160例，根据尿蛋白排泄率(UAER)分为微量白蛋白尿组(n=80)与正常白蛋白尿组(n=80)，同时选取我院同期健康体检者80例作为对照组，采用酶联免疫吸附试验(ELISA法)检测血清LPPLA2水平，化学发光法检测血清25(OH)D3水平，全自动生化分析仪检测生化指标，对比3组血清LPPLA2、25(OH)D3水平变化，分析其与早期DN的相关性。结果 ①正常白蛋白尿组及微量白蛋白尿组血清LPPLA2水平明显高于对照组，血清25(OH)D3明显低于对照组(均P<0.05), 而正常白蛋白尿组血清LPPLA2低于微量白蛋白尿组，血清25(OH)D3高于微量白蛋白尿组(均P<0.05)。②微量白蛋白尿组UAER与低密度脂蛋白胆固醇(LDLC)、收缩压(SBP)、舒张压(DBP)、病程、血糖(FPG)、糖化血红蛋白(HbA1c)、尿酸(UA)、同型半胱氨酸(Hcy)、胱抑素C(CysC)、LPPLA2均呈正相关(均P<0.05或P<0.01)，与25(OH)D3呈负相关(P<0.01)。③SBP、DBP、病程、FPG、HbA1c、CysC、LPPLA2为早期DN的独立危险因素，25(OH)D3为其保护因素。结论血清LPPLA2、25(OH)D3与早期DN的发生、发展密切相关， LPPLA2是其危险因素，25(OH)D3是其保护因素。

关键词: 糖尿病肾病, 骨化二醇, 磷脂酶A2, 尿蛋白排泄率

Abstract: Objective To investigate the level of 25hydroxy vitamin D3 (25［OH］D3) and lipoprotein associated phospholipase A2 (LpPLA2) in diabetic nephropathy(DN) patients and explore the correlation between serum level of 25(OH)D3 and LpPLA2 and the early DN. Methods A total of 160 patients with type 2 diabetes mellitus(T2DM) were randomly divided into microalbuminuria group (n=80) and normal albuminuria group (n=80) according to the urinary albumin excretion rate (UAER). Another 80 health volunteers served as the control group. Serum LpPLA2 level was measured by enzyme linked immunoadsorption determination (ELISA). Serum 25(OH)D3 level was measured by chemiluminescence method, and the biochemical indicators were measured by automatic biochemical analyzer. The differences of LpPLA2 and 25(OH)D3 among three groups were compared, and the correlation between serum level of 25(OH)D3 and LpPLA2 and the early DN was analyzed. Results ①Seurm LpPLA2 was significantly higher in normal albuminuria and microalbuminuria group than that in control group, but serum 25(OH)D3 was significantly lower in normal albuminuria and microalbuminuria group than that in control group (P<0.05). Seurm LpPLA2 was significantly higher in microalbuminuria group than that in normal albuminuria group, but seurm 25(OH)D3 was significantly lower in microalbuminuria group than that in normal albuminuria group (P<0.05). ②The level of UAER was positively correlated with the low density lipoprotein cholesterin(LDLC), systolic blood pressure (SBP), diastolic blood pressure (DBP), disease course, fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), uric acid(UA), homocysteine(Hcy), Cys C and LpPLA2(P<0.05 or P<0.01), but was negatively correlated with 25(OH)D3 (P<0.01). ③SBP, DBP, course of sisease, FPG, HbA1c, CysC and LPPLA2 were independent risk factors for early DN, but 25(OH)D3 was protective factor for it. Conclusion The levels of 25( OH) D3 and LPPLA2 are closely related to the occurrence and development of early DN. 25(OH)D3 is the protective factor, while LPPLA2 is a risk factor for it．

Key words: diabetic nephropathy, calcifediol, phospholipases A2, urinary albumin excretion rate

毛维维，董萍. 血清25-羟维生素D3、脂蛋白相关磷脂酶A2与早期糖尿病肾病的相关性研究[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.10.010.

Mao Weiwei, Dong Ping. Correlation analysis on serum level of 25hydroxy vitamin D3 and lipoproteinassociated phospholipase A2 with early diabetic nephropathy[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.10.010.

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https://huicui.hebmu.edu.cn/CN/Y2019/V34/I10/911

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血清25-羟维生素D3、脂蛋白相关磷脂酶A2与早期糖尿病肾病的相关性研究

Correlation analysis on serum level of 25hydroxy vitamin D3 and lipoproteinassociated phospholipase A2 with early diabetic nephropathy

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