糖尿病肾病患者血清淀粉样蛋白A与血糖及血脂代谢的相关性

目的探讨血清淀粉样蛋白A(serum amyloid A,SAA)与糖尿病肾病患者血糖及血脂代谢的关系。方法 115例2型糖尿病患者依据24h尿微量白蛋白排泄率分为单纯糖尿病组37例,微量白蛋白尿组40例,临床白蛋白尿组38例,同期35名体检健康者为对照组,测定4组空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血肌酐、血尿素氮、糖化血红蛋白、血清SAA、24h尿微量白蛋白排泄率,并进行比较。结果单纯糖尿病组SAA、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平高于对照组(P<0.01);微量白蛋白尿组SAA、空腹血糖、糖化血红蛋白、总胆固醇水平高于单纯糖尿病组(P<0.05);临床白蛋白尿组糖化血红蛋白、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、SAA、血肌酐、24h尿微量白蛋白排泄率、三酰甘油水平高于微量白蛋白尿组(P<0.05);SAA与24h尿微量白蛋白排泄率、空腹血糖、糖化血红蛋白、总胆固醇呈正相关(r=0.463,P<0.01;r=0.278,P<0.05;r=0.402,P<0.01;r=0.216,P<0.05),与高密度脂蛋白胆固醇呈负相关(r=-0.265,P<0.05)。结论 SAA与空腹血糖、糖化血红蛋白、高脂血症及尿微量白蛋白关系密切,SAA水平增高是糖尿病肾病进展的重要危险因素。

Correlation of serum amyloid protein A with plasma glucose and lipid metabolism in patients with diabetic nephropathy

Objective To investigate the relationship between serum amyloid A(SAA) with plasma glucose and lipid metabolism in patients with diabetic nephropathy.Methods A total of 115 patients with type 2 diabetes mellitus were divided into three groups,simple diabetic group(n=37),microalbuminuria group(n=40) and clinical albuminuria group(n=38).Another 35 healthy volunteers were as controls.All these four groups were detected fasting plasma glucose(FPG),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),serum creatinine(SCr),blood urea nitrogen(BUN),glycosylated hemoglobin(HbA1c),SAA and urinary albumin excretion rate(UAER).Results The levels of SAA,TG,HDL-C and LDL-C were significantly higher in the simple diabetic group than those in control group(P<0.01),the levels of SAA,FPG,HbA1c and TC were significantly higher in microalbuminuria group than those in simple diabetic group(P<0.05).The levels of HbA1c,TC,HDL-C,LDL-C,SAA,SCr,UAER,and TG were significantly higher in clinical albuminuria group than those in microalbuminuria group(P<0.05).SAA was positively correlated with UAER,FPG,HbA1c and TC(r=0.463,P<0.01;r=0.278,P<0.05;r=0.402,P<0.01;r=0.216,P<0.05),and was negatively correlated with HDL-C(r=-0.265,P<0.05).Conclusion SAA is closely correlated with plasma glucose,HbA1c,hyperlipidemia and microalbuminuria in diabetic nephropathy.Increased SAA is an important risk factor of diabetic nephropathy progress.