Lin Lan, Guo Xiao-Zhou, Li Min
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2010 Sep;30(9):912-4.
To investigate the relationship of Chinese medicine syndrome pattern with urinary albumin excretion rate (UAER) and its related factors in patients with diabetic nephropathy (DN).
Sixty-three early stage DN patients were subjected to the study, the Chinese medicine syndrome patterns were differentiated, and their condition of methylene tetrahydrofolate reductase (MTHFR) C677T mutation was detected (shown by gene polymorphism of 677 base pairs). Meantime, plasma levels of homocysteine (Hcy), folic acid, fasting and postprandial glucose (FG and PG), glycohemoglobin (HbA1c), blood lipids as well as UAER were measured.
Syndrome pattern was differentiated as yin-deficiency with heat-flourishing in 17 patients, qi-yin deficiency in 24, and yin-yang deficiency in 22; while accompanied blood stasis syndrome (BSS) was found in 35. Gene polymorphism detection indicated that 19 patients were of CC-type, 17 of TT-type, and 27 of CT-type. Analysis showed that higher UAER level often revealed in patients with BSS, as compared with that in patients of non-BS pattern, the difference was statistically significant (P < 0.05). UAER levels in patients of different genotypes were insignificantly different (P > 0.05), but showed a linear regressive relation, namely positively correlated with Hcy level in patients of isogeneic type (r = 0.674, P < 0.05). No statistical significance was found between levels of UAER and other related factors (P > 0.05).
UAER level in early stage DN patients of BSS pattern is rather higher, and it shows a linear regression relationship (positive correlation) with Hcy level in patients of isogeneic type.
探讨糖尿病肾病(DN)患者中医证型与尿白蛋白排泄率(UAER)及其相关因素的关系。
对63例早期DN患者进行研究,进行中医证型辨证,并检测其亚甲基四氢叶酸还原酶(MTHFR)C677T突变情况(以677个碱基对的基因多态性表示)。同时,测定血浆同型半胱氨酸(Hcy)、叶酸、空腹及餐后血糖(FG和PG)、糖化血红蛋白(HbA1c)、血脂以及UAER水平。
辨证为阴虚热盛型17例,气阴两虚型24例,阴阳两虚型22例;兼血瘀证(BSS)者35例。基因多态性检测显示,CC型19例,TT型17例,CT型27例。分析表明,与非BSS型患者相比,BSS型患者UAER水平往往较高,差异有统计学意义(P<0.05)。不同基因型患者的UAER水平差异无统计学意义(P>0.05),但呈线性回归关系,即同基因类型患者中与Hcy水平呈正相关(r=0.674,P<0.05)。UAER水平与其他相关因素之间差异无统计学意义(P>0.05)。
BSS型早期DN患者的UAER水平较高,且同基因类型患者中与Hcy水平呈线性回归关系(正相关)。