[1]何晓红,翁孝刚.2型糖尿病患者血清1,25-二羟维生素D3与糖尿病肾病的相关性[J].新乡医学院学报,2020,37(8):762-764.[doi:10.7683/xxyxyxb.2020.08.014]
　HE Xiaohong,WENG Xiaogang.Relationship between serum 1,25-dihydroxyvitamin D3 and diabetic nephropathy in patients with type 2 diabetes mellitus[J].Journal of Xinxiang Medical University,2020,37(8):762-764.[doi:10.7683/xxyxyxb.2020.08.014]
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2型糖尿病患者血清1,25-二羟维生素D3与糖尿病肾病的相关性
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年8
页码:
762-764
栏目:
临床研究
出版日期:
2020-08-05

文章信息/Info

Title:
Relationship between serum 1,25-dihydroxyvitamin D3 and diabetic nephropathy in patients with type 2 diabetes mellitus
作者:
何晓红1; 翁孝刚2
（1.新乡医学院第三临床学院，河南　新乡　453003；2.新乡医学院第三附属医院内分泌科，河南　新乡　453003）
Author(s):
HE Xiaohong1; WENG Xiaogang2
(1.The Third Clinical College of Xinxiang Medical University，Xinxiang 453003，Henan Province，China;2.Department of Endocrinology，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province，China)
关键词:
糖尿病肾病; 1; 25-二羟维生素D3 ; 尿白蛋白/肌酐比值; 肾小球滤过率
Keywords:
diabetic nephropathy; 1; 25-(OH)2D3; urine albumin/creatinine ratio; glomerular filtration rate
分类号:
R587.1
DOI:
10.7683/xxyxyxb.2020.08.014
文献标志码:
A
摘要:
目的　探讨2型糖尿病患者血清1,25-二羟维生素D3［1,25-（OH）2D3］水平与糖尿病肾病 (DN) 的关系。方法　选择2018年3月至2019 年9月新乡医学院第三附属医院收治的300例2型糖尿病患者为研究对象，采用免疫比浊法及苦味酸法分别测定尿白蛋白和尿肌酐，计算尿白蛋白/肌酐比值(UACR），根据UACR将患者分为正常蛋白尿组（UACR<30 mg·g-1，n=95）、微量蛋白尿组（30 mg·g-1≤UACR<300 mg·g-1，n=90)及临床蛋白尿组（UACR≥300 mg·g-1，n=115)。采用酶联免疫吸附试验(ELISA)法检测血清1,25-(OH)2D3水平；采用全自动生物化学分析仪和ELISA法测定血清肌酐（SCr)、尿素氮（BUN)水平,并计算肾小球滤过率（GFR）。观察各组患者血清1,25-(OH)2D3水平与UACR、GFR、SCr、BUN的关系。结果　微量蛋白尿组、临床蛋白尿组患者血清1,25-(OH)2D3水平显著低于正常蛋白尿组（P<0.05) ，临床蛋白尿组患者血清1,25-(OH)2D3水平显著低于微量蛋白尿组(P<0.05)。3组患者血清BUN水平比较差异无统计学意义 (P>0.05)。微量蛋白尿组、临床蛋白尿组患者血SCr水平显著高于正常蛋白尿组(P<0.05),临床蛋白尿组患者血SCr水平显著高于微量蛋白尿组 (P<0.05) 。 微量蛋白尿组、临床蛋白尿组患者血清GFR水平显著低于正常蛋白尿组,临床蛋白尿组患者血清GFR水平显著低于微量蛋白尿组(P<0.05)。多因素logistic回归分析显示，年龄及1,25-(OH)2D3 水平是DN的独立危险因素。Pearson相关分析显示，1,25-(OH)2D3与UACR、SCr呈负相关(r=-0.257、-0.145,P<0.05)，与GFR呈正相关(r=0.389，P<0.05)，与BUN无显著相关性(r=0.256，P>0.05)。结论　DN的发生、发展可能与1,25-(OH)2D3水平降低有关，在控制血压、血糖、血脂等指标的基础上早期筛查血清1,25-(OH)2D3水平并及时补充维生素D 对延缓DN的发生、发展可能有一定临床意义。
Abstract:
Objective　To explore the relationship between serum 1,25-dihydroxyvitamin D3［1,25-(OH)2D3］ level and diabetic nephropathy(DN) in patients with type 2 diabetes mellitus(T2DM).Methods　Three hundreds patients with T2DM who were admitted to the Third Affiliated Hospital of Xinxiang Medical University from March 2018 to September 2019 were selected as the research subjects.Urine albumin and creatinine were measured by immunoturbidimetric method and picric acid method respectively,and urine albumin/creatinine ratio(UACR) was calculated.According to the UACR,the patients were divided into normal proteinuria group(UACR<30 mg·g-1,n=95),microalbuminuria group(30 mg·g-1≤UACR<300 mg·g-1,n=90) and clinical proteinuria group(UACR≥300 mg·g-1,n=115).The enzyme-linked immunosorbent assay(ELISA) method was used to detect the serum 1,25-(OH)2D3levels;the automatic biochemical analyzer and ELISA method were used to determine the serum creatinine(SCr) and urea nitrogen(BUN) levels,and glomerular filtration rate(GFR) was calculated.The relationship between serum 1,25-(OH)2D3 level and UACR,GFR,SCr and BUN in each group were observed. Results　The level of serum 1,25-(OH)2D3 in the microalbuminuria group and clinical proteinuria group was lower than that of the normal proteinuria group (P<0.05),and the serum 1,25-(OH)2D3 level of patients in the clinical proteinuria group was lower than that in the microalbuminuria group (P<0.05).There was no significant difference in serum BUN level among the three groups(P>0.05).The serum SCr level of patients in the microproteinuria group and clinical proteinuria group was significantly higher than that in the normal proteinuria group,and the serum SCr level in the clinical proteinuria group was significantly higher than that in the microproteinuria group(P<0.05).Serum 1,25-(OH)2D3 levels of patients in the microproteinuria group and clinical proteinuria group were significantly lower than that in normal proteinuria group,and the difference was statistically significant(P<0.05);the serum 1,25-(OH)2D3 level in the clinical proteinuria group was lower than that in the microalbuminuria group(P<0.05).Serum GFR level of patients in the microalbuminuria group and clinical proteinuria group were significantly lower than that in the normal proteinuria group.Serum GFR level of patients in the clinical proteinuria group was lower than that in the microalbuminuria group(P<0.05).Multivariate logistic regression analysis showed that age and 1,25-(OH)2D3 level were independent risk factors for DN patients.Pearson correlation analysis showed that 1,25-(OH)2D3 was negatively correlated with UACR and SCr(r=-0.257,-0.145;P<0.05) and positively correlated with GFR(r=0.389，P<0.05).However,there was no obvious correlation with BUN(r=0.256,P>0.05).Conclusion　The occurrence and development of DN may be related to the decrease of 1,25-(OH)2D3 level.Based on the control of blood pressure,blood sugar,blood lipids and other indicators,early screening of serum 1,25-(OH)2D3 concentration and timely Vitamin D supplementation may have some clinical significance to delay the occurrence and development of DN.

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更新日期/Last Update: 2020-08-05