·糖尿病慢性肾脏病变·

　　【摘要】 目的 探讨血浆ghrelin在T2DM合并慢性肾脏疾病(CKD)发生发展中的作用。 方法 根据24 h尿白蛋白排泄率(UAER)，将105例T2DM患者分为正常白蛋白尿组(NA组)39例、微量白蛋白尿组(MA组)36例、临床白蛋白尿组(CP组)30例，另选健康对照者35例为对照(NC)组。测定研究对象血浆ghrelin、血糖、血脂、UAER、血BUN、Scr，比较各组间的差异。 结果 NA组血浆ghrelin较NC组下降(P<0.05)，MA组及CP组患者血浆ghrelin均高于NA组(P<0.05或P<0.01)，CP血浆ghrelin高于MA组(P<0.05)。相关分析显示，血浆ghrelin与BMI、HbA1c、FPG呈负相关(r=﹣0.420、﹣0.458、0.433，P<0.05);与UAER、Scr、ISI呈正相关(r=0.322、0.601、0.477，P<0.05)。多元线性回归分析显示，BMI、UAER、HbA1c是糖尿病患者ghrelin独立相关因素。 结论 血浆ghrelin随白蛋白尿严重程度而逐渐升高，其可能与CKD发生和发展密切相关。

　　【关键词】 糖尿病慢性肾脏疾病;尿白蛋白排泄率;ghrelin

Changes in the level of serum ghrelin in type 2 diabetic patients with chronic kidney disease LI Jian, WANG Huai-guo. Department of Endocrinology, Liaocheng Hospital, 252000 Liaocheng, China

　　【Abstract】 Objective To explore the role of serum ghrelin in the pathogenesis and progress of chronic kidney disease in T2DM. Methods A total of 105 patients with T2DM were divided into normal albuminuria group(NA group，n=39), micro-albuminuria group(MA group, n=36), and macro-albuminuria group(CP group,n=30 ) according to the urinary albumin excretion rate(UAER). Another healthy subjects (n=35) were included as control (NC) group. Serum level of ghrelin was measured by enzyme linked immunosorbent assay (ELISA). Levels of fasting plasma glucose(FPG), HbA1c, triglyceride, total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), blood urea nitrogen(BUN), serum creatinine(Scr) and UAER were determined. Results Levels of serum ghrelin were lower in NA group than in NC group(P<0.05)and higher in both MA and CP group than in NA group(P<0.05 or P<0.01). Levels of ghrelin were positively correlated with UAER、CR、ISI, while negatively correlated with BMI、HbA1c、FPG. Multiple linear regression analysis showed that BMI、UAER、HbA1c were independent factors to the plasma levels of ghrelin in the NA、MA and CP groups. Conclusion Ghrelin may play an important roles in the occurrence of the CKD in T2DM.

　　【Key words】 Diabetic Nephropathy; ghrelin; urinary albumin excretion rate