·糖尿病性肾脏疾病·

　　【摘要】 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。

　　【关键词】 糖尿病，2型;糖尿病慢性肾脏疾病;YKL-40

　　The changes and clinical significance of serum YKL-40 level in type 2 diabetic patients with chronic kidney disease ZHU Hui-jing，YANG Ming-ming，CHENG Lin，et al. Department of Endocrinology，Heze Municipal Hospital，Heze 274000，China

　　Corresponding author：CHENG Xing-bo，E-mail：huijing1012@126.com

　　【Abstract】 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.

　　【Key words】 Diabetes mellitus，type 2;Chronic kidney disease (CKD) in diabetes;