糖尿病肾病患者血清1,25-二羟维生素D_3水平变化
|
摘要
目的观察血清1,25-二羟维生素D_3[1,25-(OH)_2D_3]水平在糖尿病肾病(DN)进展中的变化。方法选择2013年8月至2015年5月深圳市龙岗中心医院收治的2型糖尿病患者157例,按照Mogensen分期标准将患者分为单纯糖尿病(DM)组(n=36)、早期DN(EDN)组(n=38)、临床DN(CDN)组(n=42)和DN终末期(ESDN)组(n=41),另选择同期体检健康者36例作为对照组。对5组受试者的尿白蛋白排泄率(UAER)、肾小球滤过率(GFR)及血清1,25-(OH)_2D_3水平进行比较。结果对照组与DM组患者UAER、GFR比较差异均无统计学意义(P>0.05);EDN组、CDN组和ESDN组患者UAER显著高于对照组和DM组(P<0.05),EDN组、CDN组和ESDN组患者GFR显著低于对照组和DM组(P<0.05);CDN组和ESDN组患者UAER显著高于EDN组(P<0.05),但CDN组与ESDN组患者UAER比较差异无统计学意义(P>0.05);ESDN组患者GFR显著低于EDN组和CDN组(P<0.05),但EDN组与CDN组患者GFR比较差异无统计学意义(P>0.05)。DM组、EDN组、CDN组和ESDN组患者血清1,25-(OH)_2D_3水平显著低于对照组(P<0.05),EDN组、CDN组和ESDN组患者血清1,25-(OH)_2D_3水平显著低于DM组(P<0.05),CDN组和ESDN组患者血清1,25-(OH)_2D_3水平显著低于EDN组(P<0.05),ESDN组患者血清1,25-(OH)_2D_3水平显著低于CDN组(P<0.05)。Pearson相关分析显示,糖尿病患者血清1,25-(OH)_2D_3水平与GFR呈正相关(r=0.389,P<0.001),与UAER呈负相关(r=-0.450,P<0.001)。结论 DN患者血清1,25-(OH)_2D_3水平显著降低,检测血清1,25-(OH)_2D_3水平可能对早期发现DN及其病情判断有积极意义。
Objective To observe the changes in serum 1,25-dihydroxyvitamin D_3[1,25-( OH)_2D_3]level in the progress of diabetic nephropathy( DN). Methods A total of 157 patients with type 2 diabetes mellitus were selected from August2013 to May 2015 in Longgang Central Hospital of Shenzhen City. The patients were divided into diabetes mellitus( DM) group( n = 36),early DN( EDN) group( n = 38),clinical DN( CDN) group( n = 42) and end stage DN( ESDN) group( n = 41) according to Mogensen staging standards. Another 36 healthy subjects were selected as control group. The urinary albumin excretion rate( UAER),glomerular filtration rate( GFR) and serum 1,25-( OH)_2D_3level were compared in the five groups. Results There was no significant difference in UAER and GFR between the control group and DM group( P > 0. 05). The UAER in EDN group,CDN group and ESDN group was significantly higher than that in control group and DM group( P < 0. 05). The GFR in EDN group,CDN group and ESDN group was significantly lower than that in control group and DM group( P < 0. 05).The UAER in CDN group and ESDN group was significantly higher than that in EDN group( P < 0. 05),but there was no significant difference in UAER between the CDN group and ESDN group( P > 0. 05). The GFR in ESDN group was significantly lower than that in EDN group and CDN group( P < 0. 05),but there was no significant difference in GFR between EDN group and CDN group( P > 0. 05). The level of serum 1,25-( OH)_2D_3in DM group,EDN group,CDN group and ESDN group was significantly lower than that in control group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in EDN group,CDN group and ESDN group was significantly lower than that in DM group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in CDN group and ESDN group was significantly lower than that in EDN group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in ESDN group was significantly lower than that in CDN group( P < 0. 05). Pearson correlation analysis showed that the serum 1,25-( OH)_2D_3level was positively correlated to GFR( r = 0. 389,P < 0. 001),and the serum 1,25-( OH)_2D_3level was negatively correlated to UAER( r =-0. 450,P < 0. 001). Conclusion The level of serum 1,25-( OH)_2D_3in DN patients decreases obviously. The detection of serum 1,25-( OH)_2D_3may be helpful in the early diagnosis and evaluation of DN.
Objective To observe the changes in serum 1,25-dihydroxyvitamin D_3[1,25-( OH)_2D_3]level in the progress of diabetic nephropathy( DN). Methods A total of 157 patients with type 2 diabetes mellitus were selected from August2013 to May 2015 in Longgang Central Hospital of Shenzhen City. The patients were divided into diabetes mellitus( DM) group( n = 36),early DN( EDN) group( n = 38),clinical DN( CDN) group( n = 42) and end stage DN( ESDN) group( n = 41) according to Mogensen staging standards. Another 36 healthy subjects were selected as control group. The urinary albumin excretion rate( UAER),glomerular filtration rate( GFR) and serum 1,25-( OH)_2D_3level were compared in the five groups. Results There was no significant difference in UAER and GFR between the control group and DM group( P > 0. 05). The UAER in EDN group,CDN group and ESDN group was significantly higher than that in control group and DM group( P < 0. 05). The GFR in EDN group,CDN group and ESDN group was significantly lower than that in control group and DM group( P < 0. 05).The UAER in CDN group and ESDN group was significantly higher than that in EDN group( P < 0. 05),but there was no significant difference in UAER between the CDN group and ESDN group( P > 0. 05). The GFR in ESDN group was significantly lower than that in EDN group and CDN group( P < 0. 05),but there was no significant difference in GFR between EDN group and CDN group( P > 0. 05). The level of serum 1,25-( OH)_2D_3in DM group,EDN group,CDN group and ESDN group was significantly lower than that in control group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in EDN group,CDN group and ESDN group was significantly lower than that in DM group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in CDN group and ESDN group was significantly lower than that in EDN group( P < 0. 05). The level of serum 1,25-( OH)_2D_3in ESDN group was significantly lower than that in CDN group( P < 0. 05). Pearson correlation analysis showed that the serum 1,25-( OH)_2D_3level was positively correlated to GFR( r = 0. 389,P < 0. 001),and the serum 1,25-( OH)_2D_3level was negatively correlated to UAER( r =-0. 450,P < 0. 001). Conclusion The level of serum 1,25-( OH)_2D_3in DN patients decreases obviously. The detection of serum 1,25-( OH)_2D_3may be helpful in the early diagnosis and evaluation of DN.
引文
[1]FENGAO L,PING L,XIN Z,et al.1,25-(OH)2D3-mediated amelioration of aortic injury in streptozotocin-induced diabetic rats[J].Inflammation,2013,36(6):1334-1343.
[2]周丽华.血清25-羟维生素D3水平与老年2型糖尿病患者周围神经病变的相关性[J].新乡医学院学报,2017,34(2):136-138.
[3]王剑清,刘艳明.维生素D调控儿童肥胖、胰岛素抵抗及其机制的研究进展[J].中华实用儿科临床杂志,2015,30(20):1598-1600.
[4]JIAO Z Z,LI Y,FAN P,et al.1,25-(OH)2D3prolongs islet graft survival by inflammatory inhibition[J].Transplant Proc,2014,46(5):1615-1620.
[5]段晓星,常永丽,智淑清,等.早期糖尿病肾病患者1,25-(OH)2D3及炎性因子的变化及骨化三醇胶丸的干预作用[J].疑难病杂志,2014,13(4):378-380.
[6]郭欣,洪建国,周小建.细菌溶解产物和1,25-二羟维生素D3对支气管哮喘小鼠呼吸道炎症的影响[J].中华实用儿科临床杂志,2016,31(12):936-939.
[7]胡小俊.1,25-二羟维生素D3对糖尿病肾病的保护作用研究进展[J].中华实用诊断与治疗杂志,2014,27(6):526-528.
[8]王成,罗雪梅,李介民.维生素D与心脏自主神经功能[J].中华实用儿科临床杂志,2015,30(1):6-9.
[9]吴欣,蒋文勇,刘倩,等.1,25-二羟维生素D3对高糖诱导的肾小管上皮细胞转分化的影响[J].实用医学杂志,2012,28(13):2159-2161.
[10]杨萍,孙书明.血清25羟维生素D3水平与2型糖尿病视网膜病变的关系研究[J].眼科新进展,2014,34(6):583-585.
[11]沙立萍,梁海艳,雷红.血清25-羟维生素D水平与2型糖尿病的相关性分析[J].宁夏医学杂志,2015,37(3):244-245.
[12]JUN W,HIROFUMI M.Inflammation and the pathogenesis of diabetic nephropathy[J].Clin Sci,2013,124(3):139-152.
[13]PAPALE M,DI PAOLO S,VOCINO G,et al.Proteomics and diabetic nephropathy:what have we learned from a decade of clinical proteomics studies[J].J Nephrol,2014,27(3):221-228.
[14]ZHANG W,WEIMIN Y U,REN X,et al.Inflammation in diabetic nephropathy[J].Mediat Inflamm,2014,2012(5):146-154.
[2]周丽华.血清25-羟维生素D3水平与老年2型糖尿病患者周围神经病变的相关性[J].新乡医学院学报,2017,34(2):136-138.
[3]王剑清,刘艳明.维生素D调控儿童肥胖、胰岛素抵抗及其机制的研究进展[J].中华实用儿科临床杂志,2015,30(20):1598-1600.
[4]JIAO Z Z,LI Y,FAN P,et al.1,25-(OH)2D3prolongs islet graft survival by inflammatory inhibition[J].Transplant Proc,2014,46(5):1615-1620.
[5]段晓星,常永丽,智淑清,等.早期糖尿病肾病患者1,25-(OH)2D3及炎性因子的变化及骨化三醇胶丸的干预作用[J].疑难病杂志,2014,13(4):378-380.
[6]郭欣,洪建国,周小建.细菌溶解产物和1,25-二羟维生素D3对支气管哮喘小鼠呼吸道炎症的影响[J].中华实用儿科临床杂志,2016,31(12):936-939.
[7]胡小俊.1,25-二羟维生素D3对糖尿病肾病的保护作用研究进展[J].中华实用诊断与治疗杂志,2014,27(6):526-528.
[8]王成,罗雪梅,李介民.维生素D与心脏自主神经功能[J].中华实用儿科临床杂志,2015,30(1):6-9.
[9]吴欣,蒋文勇,刘倩,等.1,25-二羟维生素D3对高糖诱导的肾小管上皮细胞转分化的影响[J].实用医学杂志,2012,28(13):2159-2161.
[10]杨萍,孙书明.血清25羟维生素D3水平与2型糖尿病视网膜病变的关系研究[J].眼科新进展,2014,34(6):583-585.
[11]沙立萍,梁海艳,雷红.血清25-羟维生素D水平与2型糖尿病的相关性分析[J].宁夏医学杂志,2015,37(3):244-245.
[12]JUN W,HIROFUMI M.Inflammation and the pathogenesis of diabetic nephropathy[J].Clin Sci,2013,124(3):139-152.
[13]PAPALE M,DI PAOLO S,VOCINO G,et al.Proteomics and diabetic nephropathy:what have we learned from a decade of clinical proteomics studies[J].J Nephrol,2014,27(3):221-228.
[14]ZHANG W,WEIMIN Y U,REN X,et al.Inflammation in diabetic nephropathy[J].Mediat Inflamm,2014,2012(5):146-154.