吉林大学学报(医学版)

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2型糖尿病和糖尿病并发肾病患者糖化白蛋白及其相关代谢标志物水平的检测及其意义

王晓琴1,马燕粉1,陈葳1,胡健1,王敏娟1,李锐成2,郭炫1   

  1. 1.西安交通大学医学院第一附属医院检验科,陕西 西安 710061;2.第四军医大学唐都医院检验科,陕西 西安  710038
  • 收稿日期:2013-01-02 出版日期:2013-09-28 发布日期:2013-12-13
  • 通讯作者: 郭炫(Tel:029-85323702,E-mail:guox9512@163.com) E-mail:guox9512@163.com
  • 作者简介:王晓琴(1971-),女,陕西省西安市人,副教授,医学博士,主要从事临床免疫与分子诊断学的研究。
  • 基金资助:

    陕西省科技厅科学技术研究发展计划项目资助课题(2003K10-G101)

Detection of glycated albumin and  its  related metabolic markers in patients with type 2 diabetes mellitus or diabetic nephropathy and clinical significance

WANG Xiao-qin1,MA Yan-fen1,CHEN Wei1,HU Jian1,WANG Min-juan1,LI Rui-cheng2,GUO Xuan1   

  1. 1.Department of Clinical Laboratory,First Affiliated Hospital,Medical College,Xi’an Jiaotong University,Xi’an 710061,China;2.Department of Clinical Laboratory,Tangdu Hospital,Forth Military Medical University.Xi’an 710038,China
  • Received:2013-01-02 Online:2013-09-28 Published:2013-12-13

摘要:

[摘 要] 目的:检测2型糖尿病及糖尿病并发肾病(DN)患者糖化白蛋白(GA)、糖化血红蛋白(HbA1c)、血脂和同型半胱氨酸(Hcy)等代谢标志物的表达水平,分析上述指标与尿微量白蛋白/肌酐比值(ACR)的相关性,探讨GA、HbA1c等代谢标志物对糖尿病及DN早期诊断及治疗监测的意义。方法:选取178例糖尿病患者作为病例组(其中70例单纯糖尿病患者,108例DN患者),病例组患者按ACR分为糖尿病无肾病组(正常清蛋白尿组)、早期DN组(微量白蛋白尿组)和临床DN组(大量白蛋白尿组)。另选100名健康人作为对照组。分别记录所有受检者年龄、性别,检测身高、体质量、血压、甘油三酯(TG)、总胆固醇(TC)、脂蛋白a (Lpa)、Hcy、HbA1c、GA、尿微量清蛋白及尿肌酐,计算ACR并进行比较,分析各项指标水平的改变与糖尿病DN的相关性。结果:与对照组比较,病例组患者的GA、HbA1c、TG、TC、LPa和Hcy水平均有显著升高的趋势(P<0.01);3个病例组间,随着各组患者ACR的升高,其GA、HbA1c、TG、Lpa和Hcy水平均有上升趋势(P<0.05),TC水平组间比较差异无统计学意义(P>0.05); GA、HbA1c、TG、Lpa、Hcy与ACR的变化具有相关性(GA:r=0.89,HbA1c:r=0.91,TG:r=0.62,Lpa:r=0.78,Hcy:r=0.72,均P<0.05);TG、LPa、Hcy的变化与HbA1c、GA水平的改变无显著的相关性(TG:r=0.31,r=0.41,P>0.05;Lpa:r=0.27, r=0.42,P>0.05;Hcy:r=0.24,r=0.33,均P>0.05)。结论:GA及其相关标志物在2型糖尿病和DN患者中表达异常,并与病程密切相关。联合检测GA及糖尿病相关标志物对糖尿病及其并发症的早期诊断、治疗和预后有一定的临床指导意义。

关键词: 糖尿病肾病, 糖化白蛋白, 糖化血红蛋白

Abstract:

Abstract:Objective To detect the expression levels of glycated albumin (GA),glycosylated hemoglobin (HbA1c),blood fat and homocysteine (Hcy) in patients with type 2 diabetes mellitus or diabetic nephropathy(DN),and to analyze the correlation between those metabolic markers and albumin creatinine ratio (ACR),and to investigate the significance of combined detection of these markers in early diagnosis and therapeutic monitoring of diabetes mellitus and DN.Methods 178 patients including 70 patients with simple diabetes and 108 patients with DN were collected as case group.The patients were divided into simple diabetes group (normal urine group),incipient DN group (microal buminuria group) and clinical DN group (albuminuria group).Another 100 healthy  population were  collected as control group.The age,sex and the values of body height,body weight,blood pressure,triglyceride (TG),cholesterol (TC),lipoprotein a (Lpa),Hcy,HbA1c,GA,microalbuminuria(mALB),urine creatinine(CRE) and ACR of each patient were recorded;and the correlations between the values of patients in each group and their pathogenetic conditions were analyzed.Results Compared with  control group, the levels of GA,HbA1c,TG,TC,LPa,and Hcy of the patients in case group were increased significantly;among three case groups,the variations of GA,HbA1c,TG, LPa and Hcy values had statistically significant differences with the increase of ACR (P<0.05);but the  TC levels  had no statistically significant differences between various groups(P>0.05).The variations of GA,HbA1c,TG,LPa and Hcy in case group were correlated with their ACR (GA: r=0.89,HbA1c: r=0.91,TG: r=0.62,Lpa: r=0.78,Hcy: r=0.72,P<0.05);but the variations of TG,LPa and Hcy in case group had no correlation with their HbA1c and GA (TG:r=0.31,r=0.41,P>0.05;Lpa: r=0.27,r=0.42,P>0.05;Hcy: r=0.24,r=0.33,P>0.05).Conclusion GA and its related markers exist abnormal expressions in the patients with type 2 diabetes mellitus or DN,and they are closely related to the course of the disease.Combined detection of GA and diabetes related markers has certain clinical significance for early diagnosis,treatment and prognosis of diabetes and its complications.

Key words: diabetic nephropathy, glycated albumin, glycosylated hemoglobin

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