Kawasaki Y, Taniguchi A, Fukushima M, Nakai Y, Kuroe A, Ohya M, Nagasaka S, Yamada Y, Inagaki N, Seino Y
Department of Metabolism and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, and Division of Diabetes and Clinical Nutrition, Kansai-Denryoku Hospital, Osaka, Japan.
Horm Metab Res. 2005 Oct;37(10):617-21. doi: 10.1055/s-2005-870536.
The aim of this study was to investigate the relationships between albuminuria and tumor necrosis factor (TNF)-alpha or soluble TNF receptors (sTNF-R1, sTNF-R2) in eighty-eight non-obese Japanese type 2 diabetic patients stratified into two groups according to albuminuria status-microalbuminuria or normoalbuminuria. Patients with microalbuminuria were older and had significantly higher concentrations of sTNF-R1 and sTNF-R2 than those with normoalbuminuria. There was, however, no significant difference in sex, diabetes duration, smoking, BMI, systolic and diastolic blood pressure, HbA (1c), serum creatinine, and lipid profile between the two groups. Although serum TNF-alpha was positively correlated to serum sTNF-R1 and sTNF-R2, serum TNF-alpha level did not differ with respect to albuminuria. Univariate regression analysis showed that urinary albumin concentration was positively correlated to age (r=0.380, p<0.001), serum creatinine (r=0.214, p<0.05) and concentrations of sTNF-R1 (r=0.364, p<0.001) and sTNF-R2 (r=0.342, p<0.005). Other variables, including TNF-alpha, were not associated with albuminuria. Multiple regression analyses showed that urinary albumin concentration was independently predicted by the level of sTNF-R1 (F=32.1), which explained 26.3% of the variability of urinary albumin concentration. From these results, it can be concluded that serum soluble TNF receptor is an important independent factor associated with albuminuria in non-obese Japanese type 2 diabetic patients.
本研究旨在调查88名非肥胖日本2型糖尿病患者中蛋白尿与肿瘤坏死因子（TNF）-α或可溶性TNF受体（sTNF-R1、sTNF-R2）之间的关系，这些患者根据蛋白尿状况——微量蛋白尿或正常蛋白尿被分为两组。微量蛋白尿患者年龄较大，且sTNF-R1和sTNF-R2的浓度显著高于正常蛋白尿患者。然而，两组在性别、糖尿病病程、吸烟、体重指数、收缩压和舒张压、糖化血红蛋白（HbA1c）、血清肌酐和血脂谱方面无显著差异。虽然血清TNF-α与血清sTNF-R1和sTNF-R2呈正相关，但血清TNF-α水平在蛋白尿方面并无差异。单因素回归分析显示，尿白蛋白浓度与年龄（r=0.380，p<0.001）、血清肌酐（r=0.214，p<0.05）以及sTNF-R1（r=0.364，p<0.001）和sTNF-R2（r=0.342，p<0.005）的浓度呈正相关。包括TNF-α在内的其他变量与蛋白尿无关。多因素回归分析显示，尿白蛋白浓度由sTNF-R1水平独立预测（F=32.1），其解释了尿白蛋白浓度变异性的26.3%。从这些结果可以得出结论，血清可溶性TNF受体是与非肥胖日本2型糖尿病患者蛋白尿相关的重要独立因素。
