血浆Ghrelin水平与2型糖尿病的关系

发布时间：2018-11-15 19:59

【摘要】：目的观察2型糖尿病(T2DM)及2型糖尿病肾病(DN)患者血浆Ghrelin水平,探讨其与糖、脂代谢、白蛋白尿及肾功能的关系。方法检测30例正常对照及110例T2DM患者空腹血浆Ghrelin水平及血糖、血脂、血压、血肌酐、24 h尿白蛋白等。结果 T2DM患者的空腹血浆Ghrelin水平明显低于正常对照组(P0.01)。T2DM血压正常组、血脂正常组、体质量偏低组及体质量正常组患者较正常对照组空腹血浆Ghrelin水平分别降低29%、28%、30%及35%(P0.01);T2DM高血压组、高血脂组及超重组患者空腹血浆Ghrelin水平较正常对照组降低更为明显,分别为42%、40%及38%(P0.01)。T2DM高血压组、高血脂组及超重组患者较T2DM血压正常组、血脂正常及体质量偏低和正常组患者空腹血浆Ghrelin水平有所降低,但无显著差异(P0.05)。T2DM正常MAU组、MAU组及明显白蛋白尿组患者较正常对照组空腹血浆Ghrelin水平分别降低30%、33%、35%(P0.01);T2DM白蛋白尿且血清肌酐1.5 mg/dl未进入肾脏替代治疗组患者较正常对照组空腹血浆Ghrelin水平升高19%(P0.05),且较其他各组均明显升高(P0.01)。T2DM正常MAU组与MAU组及白蛋白尿组患者,随白蛋白尿的增多,空腹血浆Ghrelin水平均有所降低,但三者之间无显著差异(P0.05)。空腹血浆Ghrelin与体重指数(BMI,r=-0.309,P0.01)、Hb A1c(r=-0.264,P0.01)、收缩压(r=-0.535,P0.01)、舒张压(r=-0.604,P0.01)呈负相关;与血清肌酐水平呈正相关(r=0.330,P0.01)。多元逐步线性回归结果显示血清肌酐(β=0.326,P=0.000 9)、BMI(β=-0.265,P0.000 1)及Hb A1c(β=-0.231,P0.000 1)共同决定空腹血浆Ghrelin。结论 T2DM患者空腹血浆Ghrelin水平明显低于正常对照组;T2DM伴有高血压、高血脂、超重及白蛋白尿时空腹血浆Ghrelin水平更低;肾功能异常的T2DM患者血浆Ghrelin水平明显升高。血清肌酐、BMI及Hb A1c共同决定空腹血浆Ghrelin。
[Abstract]:Objective to observe the plasma Ghrelin levels in patients with type 2 diabetes mellitus (T2DM) and type 2 diabetic nephropathy (DN) and to explore the relationship between Ghrelin and glucose, lipid metabolism, albuminuria and renal function. Methods fasting plasma Ghrelin levels, blood glucose, blood lipids, blood pressure, creatinine, 24 h urinary albumin were measured in 30 normal controls and 110 patients with T2DM. Results the fasting plasma Ghrelin levels in patients with T2DM were significantly lower than those in normal controls (P0.01). The fasting plasma Ghrelin levels in patients with normal T2DM blood pressure, normal blood lipids, low body mass and normal body mass were 29% lower than those in normal controls, respectively. 28% and 35% (P0.01); The fasting plasma Ghrelin levels in T2DM hypertension group, hyperlipidemia group and superrecombinant group were significantly lower than those in normal control group (42%) and 38% (P0.01) respectively. T2DM hypertension group, hyperlipidemia group and hyperrecombination group were significantly lower than those in T2DM normal blood pressure group. The fasting plasma Ghrelin level in patients with normal blood lipids and low body mass was decreased, but there was no significant difference (P0.05). There was no significant difference in fasting plasma Ghrelin levels between normal and normal T2DM groups (P0.05). The fasting plasma Ghrelin levels in MAU group and significant albuminuria group were decreased by 30% and 35% (P0.01), respectively. The fasting plasma Ghrelin level in patients with T2DM albuminuria and serum creatinine 1.5 mg/dl without renal replacement therapy was increased by 19% (P0.05). With the increase of albuminuria, fasting plasma Ghrelin level decreased in T2DM normal MAU group, MAU group and albuminuria group (P0.01), but there was no significant difference among the three groups (P0.05). Fasting plasma Ghrelin was negatively correlated with body mass index (BMI,r=-0.309,P0.01), Hb A1c), systolic blood pressure (RP0.01) and diastolic blood pressure (RP0.01). There was a positive correlation between serum creatinine level and serum creatinine level (r = 0.330, P 0.01). Multiple stepwise linear regression analysis showed that serum creatinine (尾 = 0.326), BMI (尾 = -0.265), BMI (尾 = -0.265 P0.000 1) and Hb A1c (尾 = -0.231 P0.000 1) jointly determined fasting plasma Ghrelin.. Conclusion the fasting plasma Ghrelin level in T2DM patients was significantly lower than that in normal controls, the fasting plasma Ghrelin levels in patients with hypertension, hyperlipidemia, overweight and albuminuria were lower than those in normal controls, and the plasma Ghrelin levels in T2DM patients with abnormal renal function were significantly increased. Determination of fasting plasma Ghrelin. by serum creatinine, BMI and Hb A1c
【作者单位】：河北省人民医院肾内科;
【基金】：河北省引进留学人员资助项目(2016年)
【分类号】：R587.1

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