摘要
目的探讨维持性血透(MHD)治疗的2型糖尿病肾病(DN)患者血浆嗜酸性粒细胞趋化因子-2(eotaxin-2)、可溶性肿瘤坏死因子受体Ⅰ、Ⅱ(s TNFRⅠ、Ⅱ)等表达水平与代谢综合征(MS)状态的关系。方法选取接受MHD治疗3个月以上且病情稳定的DN患者30例,以首次确诊且尚未实施任何治疗的单纯2型糖尿病(T2D)患者和体检健康者各30例为对照;检测MS相关指标血压、腰围、体质指数、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、C反应蛋白(CRP)等;AAH-INF-G3抗体芯片法分析40种细胞因子的表达水平;Pearson法分析其与MS相关指标的相关性。结果 DN患者和T2D患者MS发生率分别为88.89%和33.33%。与T2D患者和健康人对照者相比,DN患者有较多的MS危险因素个数、较高的腰围和较低的体质指数;血浆eotaxin-2和趋化因子I-309水平升高,同时伴有s TNFRⅠ、Ⅱ的表达水平升高。Pearson相关分析提示,血浆eotaxin-2、I-309与MS危险因素TG、FBG及舒张压(DBP)水平等呈现明显正相关。此外,血浆s TNFRⅡ和I-309表达水平均与CRP水平呈显著正相关。结论 MHD治疗的DN患者机体内存在着消耗性MS微炎症状态。糖脂代谢的异常影响机体的免疫生理状态,造成免疫炎症微环境。eotaxin-2、I-309可能参与这种微炎症状态的慢性化、持续化,并进一步通过s TNFRⅠ、Ⅱ的上调而加重肾脏损伤,导致MHD治疗的DN患者MS状态的形成。
Objective To investigate the correlations of plasma eotaxin-2,soluble tumor necrosis factor receptor（ s TNFR） Ⅱ and other cytokines levels with the status of metabolic syndrome（ MS） in type 2 diabetic nephropathy（ DN） patients treated with maintenance hemodialysis（ MHD）. Methods Thirty type 2 DN patients with stable pathogenetic conditions and MHD treatment for more than 3months,thirty newly diagnosed and untreated type 2 diabetes（ T2D） patients and thirty healthy volunteers were enrolled in the study.The MS related markers,including blood pressure,waist circumference,body mass index,triglyceride（ TG）,high density lipoprotein cholesterol（ HDL-C）,fasting blood glucose（ FBG）,total cholesterol（ TC）,low density lipoprotein cholesterol（ LDL-C） and C reactive protein（ CRP）,were determined. The expression levels of 40 cytokines were detected with the AAH-INF-G3 antibody microarray,and their correlations with MS related markers were analyzed by the Pearson method. Results The incidence rates of MS in DN patients with MHD and T2 D patients were 88. 89% and 33. 33%,respectively. Compared with T2 D patients and healthy controls,the DN patients had more MS related markers,higher waist circumference and lower body mass index,and their plasma eotaxin-2,I-309 and s TNFRⅠ/Ⅱ levels increased significantly. Pearson correlation analysis showed that plasma eotaxin-2 and I-309 levels were positively related to MS risk factors such as TG,FBG and diastolic blood pressure（ DBP） levels. Plasma s TNFR Ⅱ and I-309 levels were significantly positively correlated with plasma CRP levels. Conclusion A micro inflammatory state exists in type 2 DN patients with MHD.Abnormal glycolipid metabolism may influence on the immunologic and physiological state of human body,and then form the micro inflammatory state. Eotaxin-2 and I-309 may participate in this chronic and persistent process and further induce renal damage by upregulating s TNFR Ⅰ/Ⅱ levels,which may result in the formation of MS state in type 2 DN patients with MHD.
作者
路萍
许化溪
苏兆亮
LU Ping XU Hua-xi SU Zhao-liang(Department of lmmunology, School of Medicine, Jiangsu University, Zhenjiang 212013, Jiangsu Department of Nephrology, the Affiliated People＇s Hospital of Jiangsu University, Zhenjiang 212001, Jiangsu, China)
出处
《临床检验杂志》
CAS
CSCD
2017年第7期507-510,共4页
Chinese Journal of Clinical Laboratory Science
基金
镇江市2014年度社会发展科技支撑项目(SH2014051)
江苏省检验医学重点实验室开放基金项目(JSKLM-2014-012)
江苏省重点研发计划项目(BE2016716)
