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目的探讨血浆Ghrelin在T2DM合并糖尿病慢性肾脏疾病(CKD)发生发展中的作用。方法根据24hUAER,将105例T2DM患者分为正常白蛋白尿组(NA)39例、微量白蛋白尿组(MA)36例及临床白蛋白尿组(CP)30例。另选健康对照者35名为对照(NC)组。测定研究对象血浆Ghrelin、血糖、血脂、UAER、血BUN及Scr水平,比较各组间差异。结果 NA组血浆Ghrelin较NC组下降(P<0.05),MA组及CP组血浆Ghrelin均高于NA组(P<0.05或P<0.01),CP组血浆Ghrelin高于MA组(P<0.05)。相关分析显示,血浆Ghrelin与BMI、HbA1c及FPG呈负相关(r=-0.420、-0.458、-0.433,P<0.05);与UAER、Scr及ISI呈正相关(r=0.322、0.601、0.477,P<0.05)。多元线性回归分析显示,BMI、UAER及HbA1c是T2DM患者Ghrelin独立相关因素。结论血浆Ghrelin随尿白蛋白严重程度而逐渐升高,可能与CKD发生发展密切相关。
Objective To investigate the role of plasma Ghrelin in the development of T2DM with diabetic chronic kidney disease (CKD). Methods According to 24hUAER, 105 patients with T2DM were divided into 39 cases of normal albuminuria (NA), 36 cases of microalbuminuria (MA) and 30 cases of clinical albuminuria (CP). Another 35 healthy controls were control (NC) groups. The plasma levels of Ghrelin, blood glucose, blood lipids, UAER, blood BUN and Scr were measured and the differences between the groups were compared. Results Plasma Ghrelin levels in NA group were significantly lower than those in NC group (P <0.05), Ghrelin in MA group and CP group were higher than those in NA group (P <0.05 or P <0.01) . Correlation analysis showed that plasma Ghrelin was negatively correlated with BMI, HbA1c and FPG (r = -0.420, -0.458, -0.433, P <0.05), and positively correlated with UAER, Scr and ISI (r = 0.322,0.601,0.477, P <0.05). Multivariate linear regression analysis showed that BMI, UAER and HbA1c were independently related to Ghrelin in T2DM patients. Conclusion Plasma Ghrelin gradually increases with the severity of urinary albumin, which may be closely related to the occurrence and development of CKD.