CAJ | 학술논문

目的：探讨不同程度糖尿病慢性肾脏疾病（CKD）患者血清YKL‐40水平的变化及其临床意义。方法按照UAlb／Cr水平将70例 T2DM 患者分为 UAlb／Cr＜30 mg／24 h组23例、UAlb／Cr 30～299 mg／24 h组24例和UAlb／Cr≥300 mg／24 h组23例，另选体检健康者20名作为健康对照（NC）组。采用ELISA检测血清YKL‐40水平。结果 T2DM各亚组血清YKL‐40水平均高于NC组，且随UAlb／Cr水平增加而增加，各组间比较差异均有统计学意义（P＜0.01）。血清 YKL‐40水平与病程、FPG、HbA1c、FIns、胰岛素抵抗指数（HOMA‐IR）、UAlb／Cr、血肌酐（Scr）呈正相关（r＝0.525、0.396、0.427、0.588、0.551、0.815、0.785，P＜0.05），与eGFR呈负相关（r＝－0.819，P＜0.05）。Logistic回归分析显示，YKL‐40是T2DM患者肾功能损伤的独立危险因素。结论 YKL‐40可能参与CKD发生发展，可在一定程度上反映CKD肾功能损伤程度。
목적：탐토불동정도당뇨병만성신장질병（CKD）환자혈청YKL‐40수평적변화급기림상의의。방법안조UAlb／Cr수평장70례 T2DM 환자분위 UAlb／Cr＜30 mg／24 h조23례、UAlb／Cr 30～299 mg／24 h조24례화UAlb／Cr≥300 mg／24 h조23례，령선체검건강자20명작위건강대조（NC）조。채용ELISA검측혈청YKL‐40수평。결과 T2DM각아조혈청YKL‐40수평균고우NC조，차수UAlb／Cr수평증가이증가，각조간비교차이균유통계학의의（P＜0.01）。혈청 YKL‐40수평여병정、FPG、HbA1c、FIns、이도소저항지수（HOMA‐IR）、UAlb／Cr、혈기항（Scr）정정상관（r＝0.525、0.396、0.427、0.588、0.551、0.815、0.785，P＜0.05），여eGFR정부상관（r＝－0.819，P＜0.05）。Logistic회귀분석현시，YKL‐40시T2DM환자신공능손상적독립위험인소。결론 YKL‐40가능삼여CKD발생발전，가재일정정도상반영CKD신공능손상정도。
Objective To explore the changes and clinical significance of serum YKL‐40 levels in T2DM with chronic kidney disease (CKD). Methods 70 T2DM patients were divided into three groups according to UAlb/Cr level:23 cases with UAlb/Cr<30 mg/24 h ,24 cases with UAlb/Cr 30~299 mg/24 h ,23 cases with UAlb/Cr≥ 300 mg/24 h. 20 healthy subjects were chosen as normal control (NC) group. Serum YKL‐40 levels were detected by ELISA. Results Serum YKL‐40 levels in each T2DM subgroup were significantly higher than NC group. With the increase of UAlb/Cr ,the YKL‐40 levels increased (P<0.01). Correlation analysis showed that serum YKL‐40 was associated with duration ,FPG ,HbA1c ,FIns , HOMA‐IR ,UAlb/Cr ,Scr and eGFR (r=0.525 ,0.396 ,0.427 ,0.588 ,0.551 ,0.815 ,0.785 ,-0.819 ,P<0.05).Logistic regression analysis showed that the level of serum YKL‐40 was an independent risk factor for renal impairment in T2DM patients. Conclusion YKL‐40 may be involved in the development and progression of CKD ,and can reflect the degree of renal impairment in some extent.