血清巨噬细胞移动抑制因子、肿瘤坏死因子-α与糖尿病肾病的相关性研究

doi:10.3969/j.issn.1006-7795.2012.03.021

首都医科大学学报 ›› 2012, Vol. 33 ›› Issue (3): 385-388.doi: 10.3969/j.issn.1006-7795.2012.03.021

血清巨噬细胞移动抑制因子、肿瘤坏死因子-α与糖尿病肾病的相关性研究

穆珺, 庄晓明, 刘锐敏, 曾静波

首都医科大学附属复兴医院内分泌科,北京 100038

收稿日期:2011-11-17 修回日期:1900-01-01 出版日期:2012-06-21 发布日期:2012-06-21
通讯作者: 庄晓明

Serum levels of MIF and TNF-α in type 2 diabetic patients with and without diabetic nephropathy

MU Jun, ZHUANG Xiao-ming, LIU Rui-min, ZENG Jing-bo

Department of Endocrinology, Fuxing Hospital, Capital Medical University, Beijing 100038,China

Received:2011-11-17 Revised:1900-01-01 Online:2012-06-21 Published:2012-06-21

摘要/Abstract

摘要： 目的探讨血清巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)、肿瘤坏死因子-α (tumor necrosis factor alpha, TNF-α)浓度在2型糖尿病(type 2 diabetes mellitus,T2DM)正常尿蛋白组及糖尿病合并肾病(diabetic nephropathy,DN)患者中的变化及其临床意义。方法将97例T2DM患者根据尿蛋白排泄率(urinary albumin excretion rate,UAER)分为正常尿蛋白组(A组,31例)、微量尿蛋白组(B组,35例)、大量尿蛋白组(C组,31例),取30例健康体检者作为对照组(D组),ELLSA方法检测各组血清MIF、TNF-α浓度,同时检测患者空腹血糖(fasting plasma glucose, FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、三酰甘油(triglycerides,TG)、总胆固醇(total cholesterol, TC)、高密度脂蛋白(high-density lipoprotein,HDL-C)、低密度脂蛋白(low-density lipoprotein,LDL-C)、尿素氮(blood urea nitrogen,BUN)肌酐(serum creatinine, Cr)。结果正常尿蛋白组(A组,31例)及糖尿病肾病(B、C)组血清MIF浓度高于正常对照组(P<0.05);糖尿病正常尿蛋白组(A组)与微量尿蛋白组(B组)、大量尿蛋白组(C组)血清MIF浓度差异无统计学意义。糖尿病肾病(B、C)组血清TNF-α高于正常对照组(P<0.05); 糖尿病肾病(B、C)组血清TNF-α高于糖尿病正常尿蛋白组(A组)。采用Spearman相关分析,血清MIF与DM病程(r=0.435,P<0.01)、HbA1c(r=0.459,P<0.01)、FBG(r=0.520,P<0.01)、TG(r=0.256,P<0.05)呈正相关,与HDL-C(r=-0.244,P<0.05)浓度呈负相关;血清TNF-α与尿A/C(r=0.254,P<0.01)、DM病程(r=0.182,P<0.05)呈正相关。Logistic回归分析结果表明,在校正年龄、糖尿病病程、BMI、HbA1c、HDL、Cr等因素后,血清TNF-α与蛋白尿的OR=1.069(95%CI: 1.005~1.137,P=0.035),血清MIF浓度与蛋白尿无相关关系。结论 2型糖尿病患者血清TNF-α浓度的变化在糖尿病肾病病程中更敏感,临床上可参考血清TNF-α浓度或同时检测血清MIF与TNF-α浓度,来判断糖尿病肾脏的损伤程度。

关键词: 2型糖尿病, 糖尿病肾病, 巨噬细胞移动抑制因子, 肿瘤坏死因子-α

Abstract: Objective To investigate the effects of serum macrophage migration inhibitory factor (MIF) , tumor necrosis factor-alpha(TNF-alpha)on diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods According to urinary albumin excretion rate (UAER),97 patients with T2DM were divided into normal albuminuria (group A, n=31), microalbuminuria group (group B,n=35), and macroalbuminuria group (group C, n=31), thirty healthy persons were included as control group (group D). The serum levels of MIF and TNF-a were tested by ELLSA technique. Results Concentration of serum MIF in group A, group B and group C was significantly higher than those in control group (P<0.05). Concentration of serum MIF in group A, group B and group C was not significantly different (P>0.05). Concentration of serum TNF-a in group B and group C was significantly higher than those in control group (P<0.05). Concentration of serum TNF-a in group B and group C were significantly higher than that in group A. Spearman correlation analysis showed that concentration of serum MIF was positively correlated with HbA1c(r=0.459,P<0.01), FBG(r=0.520,P<0.01), TG(r=0.256, P<0.05), course of disease(r=0.435, P<0.01) and was negatively correlated with HDL-C(r=-0.244,P<0.05). Concentration of serum TNF-alpha was positively correlated with UAER(r=0.254,P<0.01) and course of disease(r=0.182,P<0.05). After adjusting for age ,duration of diabetes mellitus, systolic blood pressure, body mass index, LDL cholesterol logistic regression, it was found that concentration of serum TNF-alpha was related with albuminuria. But no correlation was found with serum MIF and albuminuria. Conclusion Alteration of serum TNF-alpha may be more sensitive than serum MIF on the pathogenesis of DN in patients with T2DM. Detection of serum TNF-alpha alone or with serum MIF together may be useful to reflect the degree of renal damage in diabetic nephropathy. High Concentrations of serum MIF and TNF are risk factors that might promote the deterioration of renal function in T2DM patients with DN.

Key words: type 2 diabetes mellitus, diabetic nephropathy, macrophage migration inhibitory factor, tumor necrosis factor alpha

中图分类号:

R 587.2

穆珺;庄晓明;刘锐敏;曾静波. 血清巨噬细胞移动抑制因子、肿瘤坏死因子-α与糖尿病肾病的相关性研究[J]. 首都医科大学学报, 2012, 33(3): 385-388.

MU Jun;ZHUANG Xiao-ming;LIU Rui-min;ZENG Jing-bo. Serum levels of MIF and TNF-α in type 2 diabetic patients with and without diabetic nephropathy[J]. Journal of Capital Medical University, 2012, 33(3): 385-388.

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血清巨噬细胞移动抑制因子、肿瘤坏死因子-α与糖尿病肾病的相关性研究

Serum levels of MIF and TNF-α in type 2 diabetic patients with and without diabetic nephropathy

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