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目的探讨初诊2型糖尿病合并尿白蛋白正常患者血清25羟维生素D(25OHD)和尿PCX(UPCX)、Nephrin及单核细胞趋化蛋白-1(MCP-1)的关系。方法 2013年3至12月在我院内分泌科就诊的初诊2型糖尿病病例134例。分为正常25OHD(25OHD≥20μg/L)组及低25OHD(25OHD<20μg/L)组,测定年龄、性别、BMI、血压、PTH、TSH、25OHD、生化指标、UPCX、尿MCP-1(UMCP-1)、尿Nephrin(UNephrin)、尿UAlb和尿肌酐。结果 UPCX/UCR、UMCP-1/UCR和UNephrin水平在低25OHD组[(63.12±36.13)μg/g,(93.51±60.61)ng/g,(80.30±28.12)μg/g]较正常25OHD组[(42.41±20.63)μg/g,(51.23±32.78)ng/g,(39.66±30.3)μg/g]显著升高(P<0.05);UPCX/UCR、UMCP-1/UCR和UNephrin/UCR与25OHD水平呈负相关(r=-0.635、-0.683、-0.662,P<0.05)。25OHD是UPCX/UCR、UMCP-1/UCR和UNephrin的阴性预测因子(β=-0.832,95%CI-0.932~-0.628,P=0.000;β=-0.808,95%CI-0.901~-0.613,P=0.000;β=-0.812,95%CI-0.928~-0.701,P=0.000)。结论血清25OHD与讨初诊2型糖尿病合并尿白蛋白正常患者UPCX、Nephrin及MCP-1显著相关,是糖尿病早期肾损害的阴性预测因子。
Objective To investigate the relationship between serum 25-hydroxyvitamin D (25OHD) and urinary PCX (UPCX), Nephrin and monocyte chemoattractant protein-1 (MCP-1) in newly diagnosed type 2 diabetic patients with normal urine albumin. Methods From March to December 2013, 134 cases of newly diagnosed type 2 diabetes mellitus were treated in Department of Endocrinology. The patients were divided into normal 25OHD group (25OHD≥20μg / L) and low 25OHD group (25OHD <20μg / L), and their age, sex, BMI, blood pressure, PTH, TSH, -1), urinary Nephrin (UNephrin), urinary UAlb and urinary creatinine. Results The levels of UPCX / UCR, UMCP-1 / UCR and UNephrin were significantly lower in the 25OHD group than those in the normal 25OHD group (63.12 ± 36.13 μg / g, 93.51 ± 60.61 ng / g, 80.30 ± 28.12 μg / UPCX / UCR, UMCP-1 / UCR and UNephrin / UCR were significantly higher than those in control group (42.41 ± 20.63 μg / g, 51.23 ± 32.78 ng / g and 39.66 ± 30.3 μg / g, respectively 25OHD levels were negatively correlated (r = -0.635, -0.683, -0.662, P <0.05). 25OHD is a negative predictor of UPCX / UCR, UMCP-1 / UCR and UNephrin (β = -0.832, 95% CI -0.932-0.628, P = 0.000; β = -0.808, 95% CI -0.901 -0.613, P = 0.000; β = -0.812, 95% CI-0.928 -0.701, P = 0.000). Conclusion Serum 25OHD is significantly associated with UPCX, Nephrin and MCP-1 in patients with newly diagnosed type 2 diabetes mellitus and normal urinary albumin, which is a negative predictive factor of early diabetic nephropathy.