Steno Diabetes Center, Gentofte, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
J Diabetes Complications. 2013 Nov-Dec;27(6):604-8. doi: 10.1016/j.jdiacomp.2013.06.008. Epub 2013 Aug 20.
Urinary adiponectin (u-adiponectin) excretion has been suggested to reflect early glomerular damage. Inspired by this, we studied the levels of u-adiponectin in type 1 diabetic patients with different levels of urinary albumin excretion (UAE).
U-adiponectin was analysed by ELISA in type 1 diabetic patients: Fifty-eight with normoalbuminuria (<30mg albumin/24h), 43 with persistent microalbuminuria (30-300mg/24h) and 44 with persistent macroalbuminuria (>300mg/24h). For comparison, a control group of 55 healthy individuals was included.
U-adiponectin increased with increasing levels of UAE (p<0.01). U-adiponectin median (interquartile range): Normoalbuminuria 0.38 (0.14-1.31), microalbuminuria 1.12 (0.20-2.68), macroalbuminuria 9.20 (1.10-23.35) and controls 0.09 (0.06-0.24) μg/g creatinine. Levels were unrelated to sex, age, cholesterol, diastolic BP and BMI. U-adiponectin was weakly associated with increasing systolic BP and HbA1c (r(2)<0.1, p<0.05), but strongly related to increasing UAE (r(2)=0.57, p<0.001) and decreasing eGFR (r(2)=0.26, p<0.001). The relationship between UAE and u-adiponectin was significant in all groups and independent of eGFR, BMI, BP and HbA1c. Furthermore, u-adiponectin was associated with markers of tubular damage (p<0.01).
U-adiponectin rises with increasing levels of UAE in patients with type 1 diabetes. This is in accordance with the hypothesis that loss of adiponectin may reflect glomerular and/or tubular damage.
尿脂联素（u-adiponectin）的排泄被认为可以反映早期肾小球损伤。受此启发，我们研究了不同尿白蛋白排泄率（UAE）水平的 1 型糖尿病患者的 u-adiponectin 水平。
通过 ELISA 分析法对 1 型糖尿病患者的 u-adiponectin 进行分析：58 例患者尿白蛋白正常（<30mg 白蛋白/24h），43 例患者持续微量白蛋白尿（30-300mg/24h），44 例患者持续大量白蛋白尿（>300mg/24h）。为了进行比较，还纳入了 55 名健康个体作为对照组。
U-adiponectin 随 UAE 水平的升高而增加（p<0.01）。u-adiponectin 的中位数（四分位数范围）：尿白蛋白正常组为 0.38（0.14-1.31），微量白蛋白尿组为 1.12（0.20-2.68），大量白蛋白尿组为 9.20（1.10-23.35），对照组为 0.09（0.06-0.24）μg/g 肌酐。水平与性别、年龄、胆固醇、舒张压和 BMI 无关。u-adiponectin 与收缩压和 HbA1c 的升高呈弱相关（r²<0.1，p<0.05），但与 UAE 的升高（r²=0.57，p<0.001）和 eGFR 的降低（r²=0.26，p<0.001）呈强相关。在所有组中，UAE 与 u-adiponectin 之间的关系均具有统计学意义，且独立于 eGFR、BMI、BP 和 HbA1c。此外，u-adiponectin 与肾小管损伤标志物相关（p<0.01）。
1 型糖尿病患者的 u-adiponectin 随 UAE 水平的升高而升高。这与脂联素的丢失可能反映肾小球和/或肾小管损伤的假说一致。
