Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, 3-5 Clinicilor Street, 400006 Cluj Napoca, Romania.
Int Urol Nephrol. 2012 Aug;44(4):1151-7. doi: 10.1007/s11255-011-0064-1. Epub 2011 Oct 13.
Experimental studies have shown that adiponectin has antiproteinuric and nephroprotective effects. The purpose of the study was to assess the value of plasma adiponectin as a predictor of proteinuria in type 2 diabetes (T2D) patients.
In this one-year prospective follow-up study, we included T2D patients with positive visual test for microalbuminuria (Micral) and negative visual test for proteinuria. Exclusion criteria were: glomerular filtration ratio (GFR) < 30 ml/min, acute infection/inflammation, uncontrolled hypertension, and atherosclerotic complications. The main outcome measure was the change in urinary albumin/creatinine ratio (UACR) after 1 year follow-up (Δ UACR).
Fifty-six patients (66% males) completed the study. Their initial mean UACR was 81.58 ± 26.42 mg/g and mean GFR was 81.15 ± 3.96 ml/min. At baseline, simple regression disclosed significant correlations between UACR and plasma adiponectin (r = 0.54, P = 0.00002) and GFR (r = -0.28, P = 0.03); in multiple regression analysis, plasma adiponectin remained the only predictor of UACR (P = 0.00007). Baseline plasma adiponectin was significantly correlated to body mass index (r = -0.28, P = 0.04), waist circumference (r = -0.27, P = 0.05), HDL cholesterol (r = 0.35, P = 0.01), and LDL cholesterol (r = 0.27, P = 0.04). Baseline plasma adiponectin significantly correlated in simple (r = -0.38, P = 0.004) and multiple regression (P = 0.04) to Δ UACR. When patients were divided according to Δ UACR in nonprogressors (Δ UACR < 0) and progressors (Δ UACR > 0), logistic regression showed that baseline GFR (OR = 1.04, CI95%: 1.00-1.09, P = 0.04) and plasma adiponectin (OR = 1.16, CI95%: 1.02-1.32, P = 0.02) were the only factors that predicted whether the patient would be a progressor or not.
In T2D patients, lower plasma adiponectin levels seem to be predictive of increased UACR.
实验研究表明脂联素具有抗蛋白尿和肾脏保护作用。本研究旨在评估血浆脂联素作为 2 型糖尿病（T2D）患者蛋白尿预测因子的价值。
在这项为期一年的前瞻性随访研究中，我们纳入了微量白蛋白尿（Micral）阳性视觉检查和蛋白尿阴性视觉检查的 T2D 患者。排除标准为：肾小球滤过率（GFR）<30ml/min、急性感染/炎症、未控制的高血压和动脉粥样硬化并发症。主要观察指标为随访 1 年后尿白蛋白/肌酐比值（UACR）的变化（Δ UACR）。
56 例患者（66%为男性）完成了研究。他们的初始平均 UACR 为 81.58±26.42mg/g，平均 GFR 为 81.15±3.96ml/min。基线时，简单回归显示 UACR 与血浆脂联素（r=0.54，P=0.00002）和 GFR（r=-0.28，P=0.03）呈显著相关；多元回归分析显示，血浆脂联素仍然是 UACR 的唯一预测因子（P=0.00007）。基线时血浆脂联素与体重指数（r=-0.28，P=0.04）、腰围（r=-0.27，P=0.05）、高密度脂蛋白胆固醇（r=0.35，P=0.01）和低密度脂蛋白胆固醇（r=0.27，P=0.04）显著相关。简单回归（r=-0.38，P=0.004）和多元回归（P=0.04）均显示，基线时血浆脂联素与Δ UACR 显著相关。根据非进展者（Δ UACR<0）和进展者（Δ UACR>0）的Δ UACR 对患者进行分组后，Logistic 回归显示，基线时 GFR（OR=1.04，95%CI：1.00-1.09，P=0.04）和血浆脂联素（OR=1.16，95%CI：1.02-1.32，P=0.02）是唯一预测患者是否为进展者的因素。
在 T2D 患者中，较低的血浆脂联素水平似乎可预测 UACR 的增加。
