初诊2型糖尿病合并尿白蛋白正常患者血清25羟维生素D和尿PCX、Nephrin及单核细胞趋化蛋白-1的关系

目的探讨初诊2型糖尿病合并尿白蛋白正常患者血清25羟维生素D(25OHD)和尿PCX(UPCX)、Nephrin及单核细胞趋化蛋白-1(MCP-1)的关系。方法 2013年3至12月在我院内分泌科就诊的初诊2型糖尿病病例134例。分为正常25OHD(25OHD≥20μg/L)组及低25OHD(25OHD<20μg/L)组,测定年龄、性别、BMI、血压、PTH、TSH、25OHD、生化指标、UPCX、尿MCP-1(UMCP-1)、尿Nephrin(UNephrin)、尿UAlb和尿肌酐。结果 UPCX/UCR、UMCP-1/UCR和UNephrin水平在低25OHD组(63.12±36.13)μg/g,(93.51±60.61)ng/g,(80.30±28.12)μg/g]较正常25OHD组(42.41±20.63)μg/g,(51.23±32.78)ng/g,(39.66±30.3)μg/g]显著升高(P<0.05);UPCX/UCR、UMCP-1/UCR和UNephrin/UCR与25OHD水平呈负相关(r=-0.635、-0.683、-0.662,P<0.05)。25OHD是UPCX/UCR、UMCP-1/UCR和UNephrin的阴性预测因子(β=-0.832,95%CI-0.932^-0.628,P=0.000;β=-0.808,95%CI-0.901-0.628,P=0.000;β=-0.808,95%CI-0.901^-0.613,P=0.000;β=-0.812,95%CI-0.928-0.613,P=0.000;β=-0.812,95%CI-0.928^-0.701,P=0.000)。结论血清25OHD与讨初诊2型糖尿病合并尿白蛋白正常患者UPCX、Nephrin及MCP-1显著相关,是糖尿病早期肾损害的阴性预测因子。

The relationship between 25 hydroxy vitamin D and urine PCX,Nephrin and MCP-1 in newly diagnosed T2DM patients with normal urinary albumin

Objective To explore the relationship between 25OHD and urinary PCX, Nephrin and MCP-1 in newly diagnosed type 2 diabetic patients with normal urinary albumin.Methods134 newly diagnosed T2DM patients with normal urinary albumin were recruited. The patients were divided into two groups： the normal 25OHD （25OHD≥20μg/L） and the low 25OHD group （25OHD〈20μg/L）. The age, gender, BMI, blood pressure, PTH, TSH, 25OHD, biochemical indexes, urinary PCX （UPCX）, urinary MCP-1（UMCP-1）, urinary Nephrin （UNephrin）, urinary UAlb and urinary creatinine （UCR） were measured.ResultsThe UPCX/UCR, UMCP-1/UCR and UNephrin levels were significantly higher in low 25OHD group, （63.12±36.13）μg/g, （93.51±60.61）ng/g, （80.30±28.12）μg/g, respectively, than in normal 25OHD group, （42.41±20.63）μg/g, （51.23±32.78）ng/g, （39.66±30.3）μg/g, respectively（P〈0.05）;The UPCX/UCR, UMCP-1/UCR and UNephrin levels were negatively correlated with 25OHD levels （r=-0.635,-0.683 and-0.662, respectively）（P〈0.05）; 25OHD was the negative predictors of UPCX/UCR, UMCP-1/UCR and UNephrin （β=-0.832, 95%CI-0.932--0.628,P=0.000;β=-0.808, 95%CI-0.901--0.613,P=0.000;β=-0.812, 95%CI-0.928--0.701,P=0.000）.ConclusionSerum 25OHD was significantly related to UPCX/UCR, UMCP-1/UCR and Unephrin in newly diagnosed type 2 diabeticpatients with normal urinary albumin.