Correlations of type 2 diabetic nephropathy with FGF-21,adiponectin,islet beta-cell function among elderly patients

doi:10.3969/j.issn.1673-8640.2016.06.006

Abstract

Abstract:

Objective To investigate the correlations of type 2 diabetic nephropathy with serum fibroblast growth factor 21（FGF-21）,adiponectin,islet beta-cell function（HOMA-β） among elderly patients. Methods A total of 98 elderly patients with type 2 diabetes mellitus were enrolled as research subjects. According to the quantitation results of 24 h urinary protein,they were classified into type 2 diabetic albuminuria group（H1 group,32 cases）,persistent micro-albuminuria group（H2 group,34 cases） and normal albuminuria group（H3 group,32 cases）. Healthy subjects with normal glucose tolerance were enrolled as control group（H0 group,35 cases）. The levels of serum FGF-21 and adiponectin were determined by enzyme-linked immunosorbent assay（ELISA）,and homeostasis model assessment was used to evaluate HOMA-β. The differences among groups were compared. Results In H0 group,low-density lipoprotein cholesterol（LDL-C）,triglyceride（TG） and fasting insulin（FINS） levels were lower than those in the other 3 groups,while high-density lipoprotein cholesterol（HDL-C） levels and HOMA-β were higher than those in the other 3 groups. The systolic blood pressure（SBP） of H1 group was higher than those in the other 3 groups. Fasting plasma glucose（FPG）,FGF-21 and adiponectin levels among 4 groups were compared pairwise,and the differences had statistical significance（P<0.05）. In H1,H2 and H3 groups' pairwise comparisons,there was statistical significance（P<0.05）. Related risk factor analysis showed that disease course,serum FGF-21,adiponectin and HOMA-β levels were independent risk factors for elderly patients with type 2 diabetic nephropathy. Conclusions The levels of FGF-21,adiponectin and HOMA-β are closely related to the degree of albuminuria in elderly patients with type 2 diabetic nephropathy. FGF-21 and adiponectin may play important roles in the occurrence and development of elderly type 2 diabetic nephropathy.

Key words: Fibroblast growth factor 21, Adiponectin, Islet beta-cell function, Albuminuria, Type 2 diabetes mellitus, Elderly

CLC Number:

R446.62

SHAO Xiaoqun, CHEN Jie, WANG Shijun, FENG Xuhui. Correlations of type 2 diabetic nephropathy with FGF-21,adiponectin,islet beta-cell function among elderly patients[J]. Laboratory Medicine, 2016, 31(6): 462-466.

Figures/Tables 3

References 12

[1]	熊晓清,冉建民,刘薇,等. 2型糖尿病合并糖尿病肾病脂联素水平变化及与血管内皮功能的关系[J]. 中国动脉硬化杂志,2012,20(3):247-251.
[2]	陈亚锋,韩其蔚,刘昌慧,等. 2型糖尿病患者凝血纤溶指标变化与糖尿病微血管病变的关系[J]. 中国老年学杂志,2003,23(12):814-815.
[3]	孔园珍,张建飞. 2型糖尿病肾病与血浆tPA、PAI-1水平及HOMA-IR的关系研究[J]. 浙江医学,2014,36(12):1070-1072.
[4]	王会岩,李艳,李校堃. FGF21的生物学功能及临床研究进展[J]. 中国医药生物技术,2010,5(6):442-445.
[5]	UEBANSO T,TAKETANI Y,YAMAMOTO H,et al.Paradoxical regulation of human FGF21 by both fasting and feeding signals:is FGF21 a nutritional adaptation factor?[J]. PLoS One,2011,6(8):e22976.
[6]	STEIN S,BACHMANN A,LSSNER U,et al.Serum levels of the adipokine FGF21 depend on renal function[J]. Diabetes Care,2009,32(1):126-128.
[7]	JIAN WX,PENG WH,JIN J,et al.Association between serum fibroblast growth factor 21 and diabetic nephropathy[J]. Metabolism,2012,61(6):853-859.
[8]	HAN SH,CHOI SH,CHO BJ,et al.Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis[J]. Metabolism,2010,59(11):1656-1662.
[9]	RISCH L,SAELY C,HOEFLE G,et a1. Relationship between glomerular filtration rate and the adipokines adiponectin,resistin and leptin in coronary patients with predominantly normal or mildly impaired renal function[J]. Clin Chim Acta,2007,376(1-2):108-113.
[10]	高宁. 不同糖耐量患者血浆Gas6水平变化及与hs-CRP、visfatin和PWV 等的关系研究[D]. 山东:山东大学,2012.
[11]	周燕,贾文芳,于健. 血清脂联素、抵抗素在2型糖尿病肾病中的水平分析[J]. 现代预防医学,2012,39(1):173-175.
[12]	CHENG X,ZHU B,JIANG F,et a1.Serum FGF-21 levels in type 2 diabetic patients[J]. Endocr Res,2011,36(4):142-148.

组别	病程（年）	年龄（岁）	例数（男/女）	SBP（kPa）	DBP（kPa）
H₀组		70.6±7.8	35（20/15）	17.6±1.9	10.8±1.1
H₁组	13.7±4.9^#△	71.2±7.4	32（18/14）	19.7±2.4^*#△	10.7±1.5
H₂组	6.9±2.2^△	70.8±7.7	34（20/14）	18.0±2.0	10.8±1.2
H₃组	3.7±1.5	69.8±7.5	32（18/14）	17.8±1.7	10.7±1.1
组别	BMI（kg/m²）	HDL-C（mmol/L）	LDL-C（mmol/L）	TG（mmol/L）	TC（mmol/L）
H0组	23.5±3.1	2.6±0.6	2.3±0.4	1.8±1.2	5.8±1.1
H1组	23.8±3.6	1.1±0.3^*	3.8±1.0^*	2.0±1.7^*	6.1±1.2
H2组	22.6±3.1	1.2±0.3^*	4.0±1.1^*	2.1±1.6^*	5.8±1.2
H3组	23.3±3.2	1.3±0.4^*	3.7±0.9^*	2.2±1.5^*	5.9±1.0
组别	FPG（mmol/L）	FINS（μIU/mL）	FGF-21（μg/L）	脂联素（mg/L）	HOMA-β
H0组	5.1±0.7	6.7±3.8	224.7±11.8	11.2±2.4	98.1±85.6
H1组	13.1±3.5^*#△	8.9±6.4^*	342.8±25.4^*#△	4.3±1.5^*#△	58.5±56.5^*
H2组	11.7±4.1^*△	8.8±6.9^*	315.6±24.9^*△	6.4±2.0^*△	58.9±55.2^*
H3组	9.1±1.2^*	7.0±3.9^*	278.4±17.8^*	8.1±2.2^*	60.2±50.6^*

组别	病程（年）	年龄（岁）	例数（男/女）	SBP（kPa）	DBP（kPa）
H₀组		70.6±7.8	35（20/15）	17.6±1.9	10.8±1.1
H₁组	13.7±4.9^#△	71.2±7.4	32（18/14）	19.7±2.4^*#△	10.7±1.5
H₂组	6.9±2.2^△	70.8±7.7	34（20/14）	18.0±2.0	10.8±1.2
H₃组	3.7±1.5	69.8±7.5	32（18/14）	17.8±1.7	10.7±1.1
组别	BMI（kg/m²）	HDL-C（mmol/L）	LDL-C（mmol/L）	TG（mmol/L）	TC（mmol/L）
H0组	23.5±3.1	2.6±0.6	2.3±0.4	1.8±1.2	5.8±1.1
H1组	23.8±3.6	1.1±0.3^*	3.8±1.0^*	2.0±1.7^*	6.1±1.2
H2组	22.6±3.1	1.2±0.3^*	4.0±1.1^*	2.1±1.6^*	5.8±1.2
H3组	23.3±3.2	1.3±0.4^*	3.7±0.9^*	2.2±1.5^*	5.9±1.0
组别	FPG（mmol/L）	FINS（μIU/mL）	FGF-21（μg/L）	脂联素（mg/L）	HOMA-β
H0组	5.1±0.7	6.7±3.8	224.7±11.8	11.2±2.4	98.1±85.6
H1组	13.1±3.5^*#△	8.9±6.4^*	342.8±25.4^*#△	4.3±1.5^*#△	58.5±56.5^*
H2组	11.7±4.1^*△	8.8±6.9^*	315.6±24.9^*△	6.4±2.0^*△	58.9±55.2^*
H3组	9.1±1.2^*	7.0±3.9^*	278.4±17.8^*	8.1±2.2^*	60.2±50.6^*

指标	FGF-21		脂联素
指标	r值	P值	r值	P值
病程	0.623	<0.01	-0.685	<0.01
FPG	0.525	<0.01	-0.522	<0.01
HDL-C	-0.362	<0.01	0.381	<0.01
LDL-C	0.423	<0.01	-0.433	<0.01
TG	0.447	<0.01	-0.380	<0.01
FINS	0.569	<0.01	-0.537	<0.01
HOMA-β	-0.613	<0.01	0.399	<0.01

指标	FGF-21		脂联素
指标	r值	P值	r值	P值
病程	0.623	<0.01	-0.685	<0.01
FPG	0.525	<0.01	-0.522	<0.01
HDL-C	-0.362	<0.01	0.381	<0.01
LDL-C	0.423	<0.01	-0.433	<0.01
TG	0.447	<0.01	-0.380	<0.01
FINS	0.569	<0.01	-0.537	<0.01
HOMA-β	-0.613	<0.01	0.399	<0.01

指标	系数值	标准误	χ²值	P值	OR值
病程	1.961	0.594	8.841	0.018	5.845
FGF-21	-0.948	0.249	25.649	0.000	0.165
脂联素	-0.557	0.208	10.528	0.008	0.615
HOMA-β	-0.611	0.186	12.574	0.000	0.503