血清及尿中微量元素铬的水平与2型糖尿病肾病的相关性分析

doi:10.3969/j.issn.1673-8640.2014.10.009

摘要/Abstract

摘要： 目的探讨血清微量元素铬(Cr)的水平与糖尿病肾病(DN)的相关性。方法采用磁性纳米材料(Fe₃O₄@ZrO₂)磁固相萃取-火焰原子吸收光谱法测定30例2型糖尿病(T2DM)患者(T2DM组)、30例DN患者(DN组)及30名健康体检者(正常对照组)血清、尿液三价铬离子(Cr³⁺)及六价铬离子(Cr⁶⁺)水平。采用放射免疫法检测血清胰岛素(INS)和C肽,同时检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbA_1c)、肌酐(SCr)、尿素氮(BUN)、半胱氨酸蛋白酶抑制剂C(Cys C)、微量白蛋白(mAlb)等生化指标。采用简化肾脏病膳食改善(MDRD)公式计算肾小球滤过率(eGFR)。结果 DN组血清Cr³⁺明显低于T2DM组和正常对照组(P<0.01),而尿Cr³⁺明显高于T2DM组和正常对照组(P<0.01);DN组血清Cr⁶⁺明显高于正常对照组(P<0.01),但与T2DM组比较差异无统计学意义(P>0.05);T2DM组血清Cr³⁺水平明显低于正常对照组(P<0.01),而尿Cr³⁺和血清Cr⁶⁺水平高于正常对照组(P<0.01)。T2DM组和DN组血清Cr³⁺与eGFR呈正相关(r=0.088,P<0.05;r=0.146,P<0.01),与HbA_1c、FBG、Cys C、SCr、mAlb呈负相关(T2DM组:r值分别为-0.098、-0.103、-0.154、-0.127、-0.355,P均<0.05;DN组:r值分别为-0.106、-0.107、-0.195、-0.150、-0.447,P均<0.05),与TC、TG、BUN不相关(T2DM组:r值分别为0.010、0.011、0.044,P均>0.05;DN组:r值分别为0.010、0.010、0.049,P均>0.05)。结论 DN患者血清铬存在不同程度的降低,尿铬离子升高。微量元素铬的水平与T2DM患者肾功能损伤的发生有一定关系。

关键词: 铬, 微量元素, 糖尿病肾病, 相关性

Abstract: Objective To investigate the levels of serum and urine trace element of chromium (Cr) and its correlation with diabetic nephropathy (DN). Methods The study enrolled 30 patients with type 2 diabetes mellitus (T2DM) (T2DM group), 30 patients with DN (DN group) and 30 healthy subjects (healthy control group). Serum and urine Cr³⁺ and Cr⁶⁺ levels were determined by magnetic nanoparticle (Fe₃O₄ @ZrO₂) combining magnetic solid-phase extraction-flame atomic absorption spectrometry. Serum insulin (INS) and C peptide were detected by radioimmunoassay method. Serum total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), fasting blood glucose(FBG), glycosylated hemoglobin A_1c (HbA_1c), creatinine(SCr),urea nitrogen(BUN), cystatin C(Cys C) and microalbumin (mAlb) were detected. The estimated glomerular filtration rate (eGFR) was calculated by modification of diet in renal disease (MDRD). Resutls The level of serum Cr³⁺ in DN group was significantly lower than those in T2DM and healthy control group(P<0.01). However, urine Cr³⁺ level was significantly higher than those in T2DM and healthy control group(P<0.01). The level of serum Cr⁶⁺ in DN group was significantly higher than that in healthy control group (P<0.01), and there was no statistical significance with that in T2DM group (P>0.05). In T2DM group, serum Cr³⁺ level was lower than that in healthy control group (P<0.01), and urine Cr³⁺ and serum Cr⁶⁺ levels were higher than those in healthy control group (P<0.01). Between DN and T2DM groups, the level of serum Cr³⁺ had positive correlation with eGFR(r=0.088, P<0.05; r=0.146, P<0.01), and there were negative correlations with HbA_1c, FBG, Cys C, SCr and mAlb(T2DM group: r=-0.098,-0.103,-0.154,-0.127 and -0.355,P<0.05; DN group: r=-0.106, -0.107, -0.195, -0.150 and -0.447, P<0.05). There was no correlation with TC, TG and BUN(T2DM group: r=0.010, 0.011 and 0.044, P>0.05; DN group: r=0.010, 0.010 and 0.049,P>0.05). Conclusions The level of serum Cr in DN group has varying degrees of reduction, but urine Cr increases. Trace element Cr has correlation with kidney injury in T2DM patients.

Key words: Chromium, Trace element, Diabetic nephropathy, Correlation

中图分类号:

Q581

刘俊峰, 鞠萍, 黄娟. 血清及尿中微量元素铬的水平与2型糖尿病肾病的相关性分析[J]. 检验医学, 2014, 29(10): 1023-1027.

LIU Junfeng, JU Ping, HUANG Juan.. Study on the correlation between the levels of serum and urine trace element of chromium with type 2 diabetic nephropathy[J]. , 2014, 29(10): 1023-1027.

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