中国糖尿病杂志
中國糖尿病雜誌
중국당뇨병잡지
CHINESE JOURNAL OF DIABETES
2015年
2期
135-139
,共5页
血管生成素样蛋白4%吡格列酮%糖尿病慢性肾脏疾病
血管生成素樣蛋白4%吡格列酮%糖尿病慢性腎髒疾病
혈관생성소양단백4%필격렬동%당뇨병만성신장질병
Angiopoietin-like protein 4 (ANGPTL4)%Pioglitazone%Chronic kidney disease (CKD) in diabetes
目的:探讨早期糖尿病慢性肾脏疾病(CKD)患者血清血管生成素样蛋白4(ANGPTL4)水平及吡格列酮(PGZ)对其影响。方法选取体检健康者92名为健康对照(NC)组、新诊断单纯T2DM患者89例为T2DM组和早期CKD患者90例为CKD组。将CKD组采用随机数字表法进一步分为联合吡格列酮治疗(PGZ)亚组45例和联合格列美脲治疗(GLI)亚组45例。采用ELISA检测血清ANGPTL4水平,观察治疗前后CKD患者血清ANGPTL4水平变化。结果NC、T2DM、CKD组血清ANGPTL4水平逐渐降低[(34. 8±4. 75)vs(31. 1±3. 65)vs(27. 1±3. 52)ng/ml,P<0. 05或P<0. 01]。血清AN‐GPTL4水平与超氧化物岐化酶(SOD)、TG呈正相关(r=0. 635、0. 526,P<0. 05或P<0. 01),与BMI、FPG、HbA1c、高敏C反应蛋白(hsC‐RP)、UAlb/Cr、VEGF、FIns、胰岛素抵抗指数(HOMA‐IR)呈负相关(r=-0. 502、-0. 624、-0. 542、-0. 520、-0. 538、-0. 566、-0. 576、-0. 509,P<0. 05或P<0. 01)。治疗后PGZ亚组血清ANGPTL4水平较治疗前升高[(31. 51±3. 87)vs(27. 60±3. 58)ng/ml,P<0. 05],UAlb/Cr降低[(88. 50±8. 90)vs(116. 20±10. 30)mg/24h,P<0. 01]。治疗后GLI亚组UAlb/Cr较治疗前降低[(99. 70±12. 80)vs(122. 40±13. 10)mg/24h,P<0. 05],血清ANGPTL4水平变化比较差异无统计学意义[(27. 20±3. 54)vs(26. 60±3. 48)ng/ml,P>0. 05]。多元线性回归分析显示,HbA1c、FIns、UAlb/Cr是血清ANGPTL4水平的独立影响因素。结论CKD患者血清ANGPTL4水平降低,吡格列酮通过增加血清ANGPTL4水平对CKD患者发挥治疗作用。
目的:探討早期糖尿病慢性腎髒疾病(CKD)患者血清血管生成素樣蛋白4(ANGPTL4)水平及吡格列酮(PGZ)對其影響。方法選取體檢健康者92名為健康對照(NC)組、新診斷單純T2DM患者89例為T2DM組和早期CKD患者90例為CKD組。將CKD組採用隨機數字錶法進一步分為聯閤吡格列酮治療(PGZ)亞組45例和聯閤格列美脲治療(GLI)亞組45例。採用ELISA檢測血清ANGPTL4水平,觀察治療前後CKD患者血清ANGPTL4水平變化。結果NC、T2DM、CKD組血清ANGPTL4水平逐漸降低[(34. 8±4. 75)vs(31. 1±3. 65)vs(27. 1±3. 52)ng/ml,P<0. 05或P<0. 01]。血清AN‐GPTL4水平與超氧化物岐化酶(SOD)、TG呈正相關(r=0. 635、0. 526,P<0. 05或P<0. 01),與BMI、FPG、HbA1c、高敏C反應蛋白(hsC‐RP)、UAlb/Cr、VEGF、FIns、胰島素牴抗指數(HOMA‐IR)呈負相關(r=-0. 502、-0. 624、-0. 542、-0. 520、-0. 538、-0. 566、-0. 576、-0. 509,P<0. 05或P<0. 01)。治療後PGZ亞組血清ANGPTL4水平較治療前升高[(31. 51±3. 87)vs(27. 60±3. 58)ng/ml,P<0. 05],UAlb/Cr降低[(88. 50±8. 90)vs(116. 20±10. 30)mg/24h,P<0. 01]。治療後GLI亞組UAlb/Cr較治療前降低[(99. 70±12. 80)vs(122. 40±13. 10)mg/24h,P<0. 05],血清ANGPTL4水平變化比較差異無統計學意義[(27. 20±3. 54)vs(26. 60±3. 48)ng/ml,P>0. 05]。多元線性迴歸分析顯示,HbA1c、FIns、UAlb/Cr是血清ANGPTL4水平的獨立影響因素。結論CKD患者血清ANGPTL4水平降低,吡格列酮通過增加血清ANGPTL4水平對CKD患者髮揮治療作用。
목적:탐토조기당뇨병만성신장질병(CKD)환자혈청혈관생성소양단백4(ANGPTL4)수평급필격렬동(PGZ)대기영향。방법선취체검건강자92명위건강대조(NC)조、신진단단순T2DM환자89례위T2DM조화조기CKD환자90례위CKD조。장CKD조채용수궤수자표법진일보분위연합필격렬동치료(PGZ)아조45례화연합격렬미뇨치료(GLI)아조45례。채용ELISA검측혈청ANGPTL4수평,관찰치료전후CKD환자혈청ANGPTL4수평변화。결과NC、T2DM、CKD조혈청ANGPTL4수평축점강저[(34. 8±4. 75)vs(31. 1±3. 65)vs(27. 1±3. 52)ng/ml,P<0. 05혹P<0. 01]。혈청AN‐GPTL4수평여초양화물기화매(SOD)、TG정정상관(r=0. 635、0. 526,P<0. 05혹P<0. 01),여BMI、FPG、HbA1c、고민C반응단백(hsC‐RP)、UAlb/Cr、VEGF、FIns、이도소저항지수(HOMA‐IR)정부상관(r=-0. 502、-0. 624、-0. 542、-0. 520、-0. 538、-0. 566、-0. 576、-0. 509,P<0. 05혹P<0. 01)。치료후PGZ아조혈청ANGPTL4수평교치료전승고[(31. 51±3. 87)vs(27. 60±3. 58)ng/ml,P<0. 05],UAlb/Cr강저[(88. 50±8. 90)vs(116. 20±10. 30)mg/24h,P<0. 01]。치료후GLI아조UAlb/Cr교치료전강저[(99. 70±12. 80)vs(122. 40±13. 10)mg/24h,P<0. 05],혈청ANGPTL4수평변화비교차이무통계학의의[(27. 20±3. 54)vs(26. 60±3. 48)ng/ml,P>0. 05]。다원선성회귀분석현시,HbA1c、FIns、UAlb/Cr시혈청ANGPTL4수평적독립영향인소。결론CKD환자혈청ANGPTL4수평강저,필격렬동통과증가혈청ANGPTL4수평대CKD환자발휘치료작용。
Objective To explore the level of angiopoietin‐like protein 4 (ANGPTL4) in patients with early chronic kidney disease (CKD ) in diabetes and the influence of pioglitazone on the level. Methods 92healthypeoplewithnormalglucosetolerancewereselectedasthecontrols(NCgroup).89 newly diagnosed T2DM were selected (T2DM group ). 90 cases of CKD group were divided into pioglitazone (PGZ) and glimepiride (GLI) treated subgroups ,45 cases in each subgroup. After treatment , serum ANGPTL4 levels were observed in CKD group. Results There were significant differences in serum ANGPTL4 levels among NC ,T2DM and CKD groups [(34.8 ± 4.75) vs (31.1 ± 3.65) vs (27.1 ± 3.52)ng/ml ,P<0.05 or P<0.01]. ANGPTL4 level was positively correlated with SOD ,TG (r=0.635 , 0.526 ,P< 0.05 or P< 0.01) ,and negatively correlated with BMI ,FPG ,HbA1c ,hsC‐RP ,UAlb/Cr , VEGF ,FIns ,HOMA‐IR (r= -0.502 ,-0.624 ,-0.542 ,-0.520 ,-0.538 ,-0.566 ,-0.576 ,-0.509 ,P< 0.05 or P < 0.01 ). In PGZ subgroup after treatment ,ANGPTL4 levels were significantly increased and UAlb/Cr significantly decreased [(31.51 ± 3.87 ) vs (27.60 ± 3.58 )ng/ml ,P < 0.05 ;(88.50 ± 8.90 ) vs (116.20 ± 10.30 )mg/24 h ,P < 0.01 ]. In GLI subgroup after treatment ,there were no significant difference in FPG and HbA1 c as compared with PGZ subgroup but ANGPTL4 levels have no significant differences after treatment ,and UAlb/Cr decreased [(27.20 ± 3.54 ) vs (26.60 ± 3.48 )ng/ml ,P > 0.05 ;(99.70 ± 12.80 ) vs (122.40 ± 13.10 )mg/24 h ,P < 0.05]. HbA1 c ,FIns ,UAlb/Cr were the independent related factors influencing ANGPTL4 of CKD patients. Conclusion Serum ANGPTL4 has a lower level in CKD patients. PGZ is effective in treating CKD. This role is associated with the increase of serum ANGPTL4.