CAJ | 학술논문

目的：观察2型糖尿病肾病(T2DN)患者血浆维生素D和肾功能生化指标变化情况,评价维生素D在T2DN发生发展中的意义。方法：对72例T2DN患者按24 h尿白蛋白定量(24 h-UAE)分为正常蛋白尿组( A组)、微量蛋白尿组( B组)和大量蛋白尿组(C组),同时选择相匹配的22名健康人作为对照组(D组)。检测4组血浆尿素(UREA)、血肌酐(Cr)、尿酸(UA)、24 h-UAE及血清25-羟维生素D3[25-(OH)D3]水平。并分析血清25-(OH)D3与肾功能指标的相关性。结果：A、B和C 3组血清25-(OH)D3水平均较D组明显降低(P<0.01),C组患者亦均较A组和B组患者明显降低(P<0.01),A组和B组差异无统计学意义(P>0.05)。 C组患者血浆UREA、Cr和24 h-UAE较A、B、D组患者明显升高(P<0.01),B组和A组患者差异均无统计学意义(P>0.05)。 A、B、C 3组T2DN患者和D组血浆UA水平差异均无统计学意义(P>0.05)。25-(OH) D3与UREA、Cr和24 h-UAE均呈负相关关系(P<0.05),与UA无相关关系(P>0.05)。结论：合并25-(OH)D3缺乏的T2DN患者可能更容易出现肾脏病变。
목적：관찰2형당뇨병신병(T2DN)환자혈장유생소D화신공능생화지표변화정황,평개유생소D재T2DN발생발전중적의의。방법：대72례T2DN환자안24 h뇨백단백정량(24 h-UAE)분위정상단백뇨조( A조)、미량단백뇨조( B조)화대량단백뇨조(C조),동시선택상필배적22명건강인작위대조조(D조)。검측4조혈장뇨소(UREA)、혈기항(Cr)、뇨산(UA)、24 h-UAE급혈청25-간유생소D3[25-(OH)D3]수평。병분석혈청25-(OH)D3여신공능지표적상관성。결과：A、B화C 3조혈청25-(OH)D3수평균교D조명현강저(P<0.01),C조환자역균교A조화B조환자명현강저(P<0.01),A조화B조차이무통계학의의(P>0.05)。 C조환자혈장UREA、Cr화24 h-UAE교A、B、D조환자명현승고(P<0.01),B조화A조환자차이균무통계학의의(P>0.05)。 A、B、C 3조T2DN환자화D조혈장UA수평차이균무통계학의의(P>0.05)。25-(OH) D3여UREA、Cr화24 h-UAE균정부상관관계(P<0.05),여UA무상관관계(P>0.05)。결론：합병25-(OH)D3결핍적T2DN환자가능경용역출현신장병변。
Objective:To evaluate the role of vitamin D in the pathogenesis of type 2 diabetic nephropathy(T2DN) by observing the changes of blood serum vitamin D and biochemical markers of renal function in patients with T2DN. Methods:According to 24 h urinary albumin excretion(24 h-UAE),72 hospitalized patients with T2DN were divided into normal albuminuria group(group A ), microalbuminuria group( group B ) and macroalbuminuria group( group C ) ,and 22 healthy people were selected as control( group D) . the levels of urea( UREA) ,creatinine( Cr) ,uric acid( UA) ,24 h-UAE and serum 25-( OH) D3 were detected;The levels of serum 25-(OH)D3 and biochemical indexes were analyzed and compared among the four groups. Results:The level of serum 25-(OH)D3 in group A,group B and group C was significantly lower than that in group D(P <0. 01);the level of serum 25-(OH)D3 in group C was significant lower than that in group A and group B(P <0. 01),but the difference was not significant between group A and group B (P>0. 05). The level of plasma UREA,Cr and 24 h-UAE in group C were significantly higher than that in group D,group A and group B(P<0. 01);but the difference was not significant between group A and group B(P >0. 05). The four groups demonstrated no significant difference in UA(P>0. 05). Serum 25-(OH)D3 was negatively related to UREA,Cr and 24 h-UAE(P<0. 05),and there was no relationship between 25-(OH)D3 and UA(P>0. 05). Conclusions:T2DN patients complicated with 25-(OH)D3 deficiency are more prone to kidney diseases.