天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2013年
7期
625-627
,共3页
肾疾病%脂联素%胰岛素抵抗%脂类%血清白蛋白%血红蛋白类%尿蛋白
腎疾病%脂聯素%胰島素牴抗%脂類%血清白蛋白%血紅蛋白類%尿蛋白
신질병%지련소%이도소저항%지류%혈청백단백%혈홍단백류%뇨단백
kidney diseases%adiponectin%insulin resistance%lipids%serum albumin%hemoglobin%urinary protein
目的探讨慢性肾脏病（CKD）非透析患者血、尿脂联素（ADPN）水平与胰岛素抵抗（IR）状态的关系。方法选择487例CKD 2~5期非透析住院患者，另30例健康体检者作为对照组。ELISA法测定血、尿ADPN，放射免疫法测定空腹胰岛素（FINS），常规检查血常规、肝肾功能、血糖、血脂和24 h尿蛋白定量、内生肌酐清除率(Ccr)以及体质量指数（BMI）。比较血、尿ADPN水平和胰岛素抵抗指数（Homa-IR）在各组间的差异，分析ADPN与Homa-IR之间的关联以及与有关指标的相关性。结果 CKD非透析患者血、尿ADPN水平以及Homa-IR均高于对照组（P<0.05），随着肾功能下降，血、尿ADPN和Homa-IR逐渐升高（P<0.05），CKD 3~5期高Homa-IR患者血ADPN值也明显升高。CKD非透析患者血、尿ADPN和Homa-IR与血脂呈正相关，与血红蛋白、血白蛋白呈负相关，与24 h尿蛋白定量呈正相关（均P<0.05）。结论 CKD非透析患者随着肾功能减退，血与尿ADPN升高、IR明显，且与血脂、血红蛋白和白蛋白以及尿蛋白具有相关性，动态监测血尿ADPN水平对判断CKD非透析患者的代谢紊乱具有一定的临床意义。
目的探討慢性腎髒病（CKD）非透析患者血、尿脂聯素（ADPN）水平與胰島素牴抗（IR）狀態的關繫。方法選擇487例CKD 2~5期非透析住院患者，另30例健康體檢者作為對照組。ELISA法測定血、尿ADPN，放射免疫法測定空腹胰島素（FINS），常規檢查血常規、肝腎功能、血糖、血脂和24 h尿蛋白定量、內生肌酐清除率(Ccr)以及體質量指數（BMI）。比較血、尿ADPN水平和胰島素牴抗指數（Homa-IR）在各組間的差異，分析ADPN與Homa-IR之間的關聯以及與有關指標的相關性。結果 CKD非透析患者血、尿ADPN水平以及Homa-IR均高于對照組（P<0.05），隨著腎功能下降，血、尿ADPN和Homa-IR逐漸升高（P<0.05），CKD 3~5期高Homa-IR患者血ADPN值也明顯升高。CKD非透析患者血、尿ADPN和Homa-IR與血脂呈正相關，與血紅蛋白、血白蛋白呈負相關，與24 h尿蛋白定量呈正相關（均P<0.05）。結論 CKD非透析患者隨著腎功能減退，血與尿ADPN升高、IR明顯，且與血脂、血紅蛋白和白蛋白以及尿蛋白具有相關性，動態鑑測血尿ADPN水平對判斷CKD非透析患者的代謝紊亂具有一定的臨床意義。
목적탐토만성신장병（CKD）비투석환자혈、뇨지련소（ADPN）수평여이도소저항（IR）상태적관계。방법선택487례CKD 2~5기비투석주원환자，령30례건강체검자작위대조조。ELISA법측정혈、뇨ADPN，방사면역법측정공복이도소（FINS），상규검사혈상규、간신공능、혈당、혈지화24 h뇨단백정량、내생기항청제솔(Ccr)이급체질량지수（BMI）。비교혈、뇨ADPN수평화이도소저항지수（Homa-IR）재각조간적차이，분석ADPN여Homa-IR지간적관련이급여유관지표적상관성。결과 CKD비투석환자혈、뇨ADPN수평이급Homa-IR균고우대조조（P<0.05），수착신공능하강，혈、뇨ADPN화Homa-IR축점승고（P<0.05），CKD 3~5기고Homa-IR환자혈ADPN치야명현승고。CKD비투석환자혈、뇨ADPN화Homa-IR여혈지정정상관，여혈홍단백、혈백단백정부상관，여24 h뇨단백정량정정상관（균P<0.05）。결론 CKD비투석환자수착신공능감퇴，혈여뇨ADPN승고、IR명현，차여혈지、혈홍단백화백단백이급뇨단백구유상관성，동태감측혈뇨ADPN수평대판단CKD비투석환자적대사문란구유일정적림상의의。
Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P<0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P<0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P < 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.
