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

发布时间：2018-11-27 12:38

【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(P0.05),而SOD、GSH-Px高于早期T2DM患者(P0.05)。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(P0.05),除了双侧RI、GFR(P0.05),上述相关性在健康人群中均无统计学意义(P0.05)。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: to compare renal function and intrarenal hemodynamics between type 2 diabetes mellitus (T2DM) patients with normal renal function and healthy subjects. To investigate the correlation between the concentration of glycosylated hemoglobin (HbA1c) and the renal hemodynamics in patients with T2DM. Methods: the renal function of 50 healthy subjects and 80 early (normal renal function) patients with T2DM were observed and the HbA1c, oxidation-related substances (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) in peripheral blood of patients with T2DM were studied. (ROS) activity and malondialdehyde (MDA) activity of reactive oxygen species and renal function (glomerular filtration rate (GFR), serum creatinine (Cr),) and (RI), renal function (glomerular filtration rate (GFR),) Serum urea nitrogen (BUN) and urinary protein excretion rate (AER),) were investigated to better monitor renal hemodynamics in early T2DM patients. Results: the ROS,MDA,GFR,Cr,BUN,AER of healthy people was lower than that of early T2DM patients (P0.05), while SOD,GSH-Px was higher than that of early T2DM patients (P0.05). There was a positive correlation between HbA1c and RI,GFR,Cr,BUN,AER, ROS,MDA and RI,GFR,. There was a positive correlation between Cr,BUN,AER and SOD,GSH-Px and a negative correlation between SOD,GSH-Px and bilateral renal RI,GFR,Cr,BUN,AER. There was no multiple linear regression relationship between renal indexes and oxidation related substances (P0.05), except bilateral RI,GFR (P0.05), the above correlation was not statistically significant in healthy population (P0.05). Conclusion: renal hemodynamic changes are present in early T2DM patients. Peripheral blood plasma oxidation-related substances and HbA1c can directly affect renal hemodynamics and provide guidance for early clinical diagnosis and treatment.
【作者单位】：沈阳医学院附属中心医院内分泌科;沈阳市第四人民医院内分泌科;
【基金】：沈阳市科技计划项目基金(F13-220-9-10)
【分类号】：R587.2;R692.9

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