Irannejad Amin, Ghajar Alireza, Afarideh Mohsen, Khajeh Elias, Noshad Sina, Esteghamati Sadaf, Afshari Khashayar, Kahe Farima, Ganji Morsaleh, Saadat Mohammad, Nakhjavani Manouchehr, Esteghamati Alireza
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Pathophysiology. 2017 Mar;24(1):17-22. doi: 10.1016/j.pathophys.2016.12.001. Epub 2016 Dec 13.
Nesfatin-1 is a newly found anorectic neuropeptide with potent metabolic regulatory effects that its circulating levels are shown to be elevated in diabetes. We compared serum nesfatin-1 in patients with type 2 diabetes and microalbuminuria (30mg/day≤urinary albumin excretion (UAE) <300mg/day) with their control patients with type 2 diabetes and normoalbuminuria (UAE <30mg/day).
In a cross sectional setting, 44 adult patients with type 2 diabetes and microalbuminuria and 44 control patients with type 2 diabetes and normoalbuminuria were evaluated. Serum levels of nesfatin-1 along with demographic, clinical and biochemical factors associated with diabetes was measured.
Mean peripheral concentrations of nesfatin-1 were significantly higher in patients with diabetes who had microalbuminuria compared to normoalbuminuric control patients (175.27±25.96pg/ml vs. 134.66±23.18pg/ml, respectively; p value<0.001). Significant positive correlations were found between circulating nesfatin-1 levels and the following case-mix variables: duration of diabetes, glycated hemoglobin, plasma creatinine, UAE and serum uric acid. In the multivariate logistic regression and after adjustment for a constellation of potentially confounding variables associated with diabetic kidney disease (DKD), circulating nesfatin-1 was the only variable significantly associated with microalbuminuria (odds ratio [95% confidence interval]=1.224 [1.007-1.487], p value=0.042).
In patients with type 2 diabetes, circulating nesfatin-1 appears to be associated with microalbuminuria independent of other established risk factors of DKD. The underlying pathophysiological mechanisms and the prognostic significance of this association remain to be elucidated.
内脂素-1是一种新发现的具有强大代谢调节作用的厌食性神经肽，其循环水平在糖尿病患者中升高。我们比较了2型糖尿病合并微量白蛋白尿（尿白蛋白排泄率（UAE）为30mg/天≤UAE＜300mg/天）患者与2型糖尿病合并正常白蛋白尿（UAE＜30mg/天）的对照患者的血清内脂素-1水平。
在一项横断面研究中，对44例2型糖尿病合并微量白蛋白尿的成年患者和44例2型糖尿病合并正常白蛋白尿的对照患者进行了评估。测量了内脂素-1的血清水平以及与糖尿病相关的人口统计学、临床和生化因素。
与正常白蛋白尿的对照患者相比，患有微量白蛋白尿的糖尿病患者外周血内脂素-1的平均浓度显著更高（分别为175.27±25.96pg/ml和134.66±23.18pg/ml；p值＜0.001）。循环内脂素-1水平与以下病例组合变量之间存在显著正相关：糖尿病病程、糖化血红蛋白、血浆肌酐、UAE和血清尿酸。在多因素逻辑回归分析中，在对一系列与糖尿病肾病（DKD）相关的潜在混杂变量进行校正后，循环内脂素-1是唯一与微量白蛋白尿显著相关的变量（优势比[95%置信区间]=1.224[1.007 - 1.487]，p值=0.042）。
在2型糖尿病患者中，循环内脂素-1似乎与微量白蛋白尿相关，独立于DKD的其他既定危险因素。这种关联的潜在病理生理机制和预后意义仍有待阐明。
