Bondor Cosmina Ioana, Potra Alina Ramona, Moldovan Diana, Rusu Crina Claudia, Ciorba Pop Mariana, Muresan Adriana, Vladutiu Dan Stefan, Kacso Ina Maria
Department of Informatics and Biostatistics, University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj, 6 Pasteur Street, 400349, Cluj-Napoca, Romania.
Int Urol Nephrol. 2015 Jul;47(7):1173-80. doi: 10.1007/s11255-015-1004-2. Epub 2015 May 14.
Adiponectin may be beneficial in incipient chronic kidney disease by antagonizing oxidative stress. We evaluated adiponectin, malondialdehyde (MDA), and superoxide dismutase (SOD), in type 2 diabetes mellitus patients (T2DP) with and without incipient nephropathy.
T2DP with glomerular filtration rate (GFR) >30 ml/min were compared with 20 healthy controls. Clinical and laboratory evaluations, levels of MDA (fluorimetric thiobarbituric test), SOD (cytochrome reduction method) and adiponectin (ELISA) were obtained.
Sixty-four patients (GFR 91.44 ± 38.50 ml/min, urinary albumin-to-creatinine ratio [UACR] 20.81 [4.64-72.88 mg/g]) were included. MDA was higher in T2DP than in controls: 3.97 (2.43-4.59) versus 1.35 (1.16-1.81) nmol/ml, p < 0.0001. MDA correlated with glycated hemoglobin (r = 0.40, p = 0.001), adiponectin (r = -0.28, p = 0.03), systolic blood pressure (r = -0.28, p = 0.03) and SOD (r = -0.35, p = 0.005); adiponectin (p = 0.01) and glycated hemoglobin (p = 0.02) remained significant predictors of MDA in multiple regression analysis. SOD was negatively correlated with glycemia (r = -0.71, p < 0.0001) and glycated hemoglobin (r = -0.5, p < 0.0001). When patients were divided according to a ROC-derived adiponectin cutoff of 8.9 µg/ml, patients with higher adiponectin had lower MDA, [2.55 (2.35-3.60) vs. 4.10 (2.89-5.31) nmol/ml, p = 0.005] but similar SOD levels. In T2DP with nephropathy (GFR < 60 ml/min or UACR > 30 mg/g), the correlation of adiponectin with MDA was stronger, (r = -0.51, p = 0.004) confirmed in multiple regression analysis (p = 0.03). Adiponectin was not correlated with MDA, and SOD was inversely related to MDA in patients without nephropathy.
Adiponectin is a significant predictor of MDA in early diabetic nephropathy, whereas SOD strongly depends only on glycemic control and is not directly related to adiponectin.
脂联素可能通过对抗氧化应激对早期慢性肾脏病有益。我们评估了伴有和不伴有早期肾病的2型糖尿病患者（T2DP）的脂联素、丙二醛（MDA）和超氧化物歧化酶（SOD）。
将肾小球滤过率（GFR）>30 ml/min的T2DP患者与20名健康对照者进行比较。进行了临床和实验室评估，测定了MDA水平（荧光硫代巴比妥酸试验）、SOD水平（细胞色素还原法）和脂联素水平（酶联免疫吸附测定法）。
纳入64例患者（GFR 91.44±38.50 ml/min，尿白蛋白与肌酐比值[UACR] 20.81[4.64 - 72.88 mg/g]）。T2DP患者的MDA高于对照组：3.97（2.43 - 4.59）对1.35（1.16 - 1.81）nmol/ml，p<0.0001。MDA与糖化血红蛋白相关（r = 0.40，p = 0.001）、脂联素相关（r = -0.28，p = 0.03）、收缩压相关（r = -0.28，p = 0.03）和SOD相关（r = -0.35，p = 0.005）；在多元回归分析中，脂联素（p = 0.01）和糖化血红蛋白（p = 0.02）仍然是MDA的显著预测因子。SOD与血糖（r = -0.71，p<0.0001）和糖化血红蛋白（r = -0.5，p<0.0001）呈负相关。当根据受试者工作特征曲线得出的脂联素临界值8.9 µg/ml对患者进行分组时，脂联素水平较高的患者MDA较低，[2.55（2.35 - 3.60）对4.10（2.89 - 5.31）nmol/ml，p = 0.005]，但SOD水平相似。在患有肾病的T2DP患者（GFR<60 ml/min或UACR>30 mg/g）中，脂联素与MDA的相关性更强，（r = -0.51，p = 0.004），多元回归分析证实（p = 0.03）。在无肾病的患者中，脂联素与MDA不相关，SOD与MDA呈负相关。
脂联素是早期糖尿病肾病中MDA的重要预测因子，而SOD仅强烈依赖于血糖控制，与脂联素无直接关系。
