中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
5期
527-529
,共3页
陈秀锋%路建饶%王新华%胡静%熊重祥%廖琳%张传富%韩海燕%陈杰
陳秀鋒%路建饒%王新華%鬍靜%熊重祥%廖琳%張傳富%韓海燕%陳傑
진수봉%로건요%왕신화%호정%웅중상%료림%장전부%한해연%진걸
非糖尿病%腹膜透析%胰岛索抵抗%应激信号
非糖尿病%腹膜透析%胰島索牴抗%應激信號
비당뇨병%복막투석%이도색저항%응격신호
Non diabetic patients%Peritoneal dialysis%Insulin resistance%Stress signal
目的 探讨非糖尿病腹膜透析患者的胰岛素抵抗与应激敏感性激酶即c-Jun氨基末端激酶(JNK)及核因子κB抑制物激酶(IKK)的关系.方法 选择非糖尿病腹膜透析时间＞3个月的连续性不卧床腹膜透析(CAPD)患者51例,健康对照组20名.测定患者空腹血糖、空腹胰岛素并计算胰岛素抵抗指数(IR),按照该指数将病例分为高IR组和低IR组.采用酶联免疫吸附测定法检测3组血浆的JNK及IKK活性.结果 非糖尿病腹膜透析患者低IR组和高IR组的稳态胰岛素抵抗指数(HOMA-IR)分别为3.57±1.46和5.01±1.40,均高于健康对照组(2.37±1.62) (F=18.17,P=0.000).高IR组的JNK及IKK活性高于低IR组[JNK:(77.54±10.01) μg/L与(56.33±9.72) μg/L,P＜0.01),IKK:(321.69±21.23) μg/L与(225.12±19.43) μg/L,P＜0.01],且两组均高于健康对照组[JNK:(21.13±4.17)μg/L,IKK:(104.01±14.22) μg/L;P均＜0.01].相关分析结果表明,非糖尿病腹膜透析患者的HOMA-IR分别与JNK和IKK活性呈正相关(r=0.67,P＜0.01和r=0.61,P＜0.01).结论 非糖尿病腹膜透析患者存在胰岛素抵抗,且与血浆JNK及IKK的活性呈正相关,提示应激信号通路可能参与了非糖尿病腹膜透析患者的胰岛素抵抗.
目的 探討非糖尿病腹膜透析患者的胰島素牴抗與應激敏感性激酶即c-Jun氨基末耑激酶(JNK)及覈因子κB抑製物激酶(IKK)的關繫.方法 選擇非糖尿病腹膜透析時間＞3箇月的連續性不臥床腹膜透析(CAPD)患者51例,健康對照組20名.測定患者空腹血糖、空腹胰島素併計算胰島素牴抗指數(IR),按照該指數將病例分為高IR組和低IR組.採用酶聯免疫吸附測定法檢測3組血漿的JNK及IKK活性.結果 非糖尿病腹膜透析患者低IR組和高IR組的穩態胰島素牴抗指數(HOMA-IR)分彆為3.57±1.46和5.01±1.40,均高于健康對照組(2.37±1.62) (F=18.17,P=0.000).高IR組的JNK及IKK活性高于低IR組[JNK:(77.54±10.01) μg/L與(56.33±9.72) μg/L,P＜0.01),IKK:(321.69±21.23) μg/L與(225.12±19.43) μg/L,P＜0.01],且兩組均高于健康對照組[JNK:(21.13±4.17)μg/L,IKK:(104.01±14.22) μg/L;P均＜0.01].相關分析結果錶明,非糖尿病腹膜透析患者的HOMA-IR分彆與JNK和IKK活性呈正相關(r=0.67,P＜0.01和r=0.61,P＜0.01).結論 非糖尿病腹膜透析患者存在胰島素牴抗,且與血漿JNK及IKK的活性呈正相關,提示應激信號通路可能參與瞭非糖尿病腹膜透析患者的胰島素牴抗.
목적 탐토비당뇨병복막투석환자적이도소저항여응격민감성격매즉c-Jun안기말단격매(JNK)급핵인자κB억제물격매(IKK)적관계.방법 선택비당뇨병복막투석시간＞3개월적련속성불와상복막투석(CAPD)환자51례,건강대조조20명.측정환자공복혈당、공복이도소병계산이도소저항지수(IR),안조해지수장병례분위고IR조화저IR조.채용매련면역흡부측정법검측3조혈장적JNK급IKK활성.결과 비당뇨병복막투석환자저IR조화고IR조적은태이도소저항지수(HOMA-IR)분별위3.57±1.46화5.01±1.40,균고우건강대조조(2.37±1.62) (F=18.17,P=0.000).고IR조적JNK급IKK활성고우저IR조[JNK:(77.54±10.01) μg/L여(56.33±9.72) μg/L,P＜0.01),IKK:(321.69±21.23) μg/L여(225.12±19.43) μg/L,P＜0.01],차량조균고우건강대조조[JNK:(21.13±4.17)μg/L,IKK:(104.01±14.22) μg/L;P균＜0.01].상관분석결과표명,비당뇨병복막투석환자적HOMA-IR분별여JNK화IKK활성정정상관(r=0.67,P＜0.01화r=0.61,P＜0.01).결론 비당뇨병복막투석환자존재이도소저항,차여혈장JNK급IKK적활성정정상관,제시응격신호통로가능삼여료비당뇨병복막투석환자적이도소저항.
Objective To investigate the relationship between stress kinases (c-Jun N-terminal kinase (JNK) and nuclear factor kappa B inhibitor kinase(IKK)) and insulin resistance induced by peritoneal dialysis in non diabetic patients.Methods Fifty-one non diabetic patients were selected as our subjects,who had received continuous ambulatory peritoneal dialysis (CAPD) at least for 3 months,and were divided into high insulin resistance(IR) group and low IR group according to IR index.Meanwhile,20 healthy people were served as our control group.The level of glucose and insulin were detected for calculating HOMA-IR which was used for evaluating the degree of insulin resistance.The activity of plasma JNK and IKK of all subjects were detected by ELISA.Results Compared with control (2.37 ± 1.62),the HOMA-IR of patients in low-IR group and high-IR group were higher(3.57 ± 0.46 and 5.01 ± 1.40 respectively; F =18.17,P =0.000).Plasma JNK and IKK activities in high-IR group were (77.54 ± 10.01) μg/L and (321.69 ±21.23) μg/L,higher than that of low-IR group((56.33 ±9.72) μg/L,(225.12 ± 19.43) μg/L respectively,P ＜0.01).The activity of plasma JNK and IKK in all patients were higher than in controls((21.13 ±4.17) μg/L,(104.01 ± 14.22) μg/L,P ＜0.01).The correlation analysis results indicated that there were the positive correlation between the insulin resistance state and the activity of plasma JNK or IKK in non diabetic patients treated with CAPD (r =0.67,P ＜ 0.01 and r =0.61,P ＜ 0.01).Conclusion Insulin resistance occur in nondiabetic patients with CAPD and correlated with the plasma JNK and IKK activity,which suggest a role of stress signal pathway in insulin resistance caused by peritoneal dialysis.
