学术论文

      糖化血红蛋白及其氧化相关物质与肾功能正常的2型糖尿病患者肾血流的相关性研究

      The correlation between renal hemodynamics and HbA1c, oxidation material in T2DM patients with normal renal function

      摘要:
      目的:比较肾功能正常的2型糖尿病(T2DM)患者与健康人的肾功能与肾内血流动力学,并探讨T2DM患者外周血糖化血红蛋白(HbA1c)浓度及其氧化相关物质与肾血流动力学的相关性.方法:观察50例健康人与80例早期(正常肾功能)T2DM患者肾功能的情况并探讨T2DM患者外周血HbA1c、氧化相关物质(超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、活性氧类物质(ROS)活性、丙二醛(MDA)浓度)与双肾内血管阻力指数(RI)、肾功能(肾小球滤过率(GFR)、血清肌酐(Cr)、血清尿素氮(BUN))及其尿蛋白排泄率(AER),并探讨其相关性,以更好的监测早期T2DM患者肾血流动力学变化.结果:健康人的ROS、MDA、GFR、Cr、BUN、AER均低于早期T2DM患者(P<0.05),而SOD、GSH-Px高于早期T2DM患者(P<0.05).HbA1c与RI、GFR、Cr、BUN、AER间呈正相关,ROS、MDA与RI、GFR、Cr、BUN、AER间呈正相关,SOD、GSH-Px与双肾RI、GFR、Cr、BUN、AER间呈负相关;肾指标与氧化相关物之间无多元线性回归关系(P>0.05),除了双侧RI、GFR (P<0.05),上述相关性在健康人群中均无统计学意义(P>0.05).结论:早期T2DM患者即存在肾脏血流动力学改变,外周血清氧化相关物质与HbA1c可以直接影响肾脏血流动力学,为临床早期诊断及治疗效果提供一定指导.
      Abstract:
      Objective:Comparing the renal hemodynamics and function between the healthy people and the T2DM patients with normal renal function,and to research the correlation between renal index and HbA1c,oxidative index in T2DM patients during the preclinical stage of diabetic nephropathy(DN).Method:We selected 50 healthy people and 80 T2DM patients with normal renal function,then detected and compared the renal hemodynamics(intrarenal RI) and function,HbA1c,oxidative index (ROS,MDA,GSH-PX,and SOD) in the two groups.Then we evaluated the correlation between renal index and HbA1c,oxidative index.Results:The ROS,MDA,GFR,Cr,BUN and AER in the healthy people were lower than T2DM patients (P< 0.05),and SOD,GSH-Px were higher than T2DM patients (P<0.05).The renal parameters were positively correlated with HbA1c and diabetes duration in large,but only the correlations of the bilateral kidney RI,GFR and to HbA1c and diabetes duration had statistical significance (P<0.05).The correlation between renal parameters and HbA1c had no statistical significance (P>0.05) in the control group.The correlation analysis between the HbA1c and RI,GFR,Cr,BUN,AER had positive correlation;the correlation analysis between the ROS,MDA and RI,GFR,Cr,BUN,AER had positive correlation;the correlation analysis between the SOD,GSH-Px and RI,GFR,Cr,BUN,AER had negative correlation.The multiple linear regression analysis between the renal function and oxidative related substances had no statistical significance (P>0.05),except the RI and GFR (P<0.05).Conclusion:The T2DM patients had the changes of intrarenal hemodynamics during the early period,the HbA1c and oxidative index can be used to evaluate the damage of intrarenal hemodynamics,and these index provide directions of diagnosis and therapy to us.
      作者: 王娇 [1] 关清华 [2] 周月宏 [1]
      Author: WANG Jiao [1] GUAN Qing-hua [2] ZHOU Yue-hong [1]
      作者单位: 沈阳医学院附属中心医院内分泌科,辽宁沈阳,110024 沈阳市第四人民医院内分泌科,辽宁沈阳,110031
      刊 名: 中国临床医学影像杂志 ISTICPKU
      年,卷(期): 2017, 28(3)
      分类号: R587.1 R445.1
      在线出版日期: 2017年4月12日
      基金项目: 沈阳市科技计划项目基金