载脂蛋白M/高密度脂蛋白胆固醇（ApoM/HDL-C）和载脂蛋白M/载脂蛋白A-I（apoM/apoA-I）比值是健康对照者和2型糖尿病患者糖尿病肾病的指标。

ApoM/HDL-C and apoM/apoA-I ratios are indicators of diabetic nephropathy in healthy controls and type 2 diabetes mellitus.

作者信息

Zhang Puhong, Gao Jialin, Pu Chun, Feng Gang, Wang Lizhuo, Huang Lizhu, Zhang Yao

机构信息

Anhui Province Key Laboratory of Biological Macro-molecules Research, Wannan Medical College, China; Department of Clinical Laboratory, The Second Affiliated Hospital of Wannan Medical College, China.

Department of Endocrinology and Genetic Metabolism, Yijishan Hospital of Wannan Medical College, China; Anhui Province Key Laboratory of Biological Macro-molecules Research, Wannan Medical College, China.

出版信息

Clin Chim Acta. 2017 Mar;466:31-37. doi: 10.1016/j.cca.2017.01.006. Epub 2017 Jan 7.

DOI:10.1016/j.cca.2017.01.006

PMID:28073663

Abstract

BACKGROUND

Apolipoprotein M (apoM) concentrations were decreased in type 2 diabetes mellitus (T2DM). ApoM was selectively expressed in renal tubular epithelial cells. We investigated the changes in plasma apoM concentrations in diabetic nephropathy (DN) patients and the potential of apoM as a biomarker of DN.

METHODS

A total of 96 DN patients and 100 age- and sex-matched diabetic non-nephropathy (non-DN) patients and 110 healthy controls were included. All T2DM patients were divided into 3 groups according to urinary albumin excretion: normoalbuminuria (n=100), microalbuminuria (n=50) and macroalbuminuria (n=46). Plasma apoM concentrations were measured by enzyme-linked immunosorbent assay.

RESULTS

DN Patients had higher plasma apoM concentrations than those in non-DN patients (22.23±11.69 vs. 18.96±7.85ng/μl, P<0.05). In addition, microalbuminuria group showed higher plasma apoM concentrations than those in normoalbuminuria group (22.67±11.40 vs. 18.96±7.85ng/μl, P<0.05). The areas under curve (AUC) of apoM using a receiver-operating characteristic (ROC) curve analysis showed that plasma apoM concentrations were not indicators for identification of DN from healthy people (AUC=0.478, P=0.585) and from T2DM (AUC=0.563, P=0.125). DN patients had higher ratios of apoM/HDL-C and apoM/apoA1 than those in healthy controls and in non-DN patients. ApoM/HDL-C and apoM/apoA1 ratios could be used as indicators for identification of DN from healthy people (AUC=0.597, P=0.016; AUC=0.665, P=0.000, respectively) and from T2DM (AUC=0.580, P=0.050; AUC=0.601, P=0.015, respectively).

CONCLUSIONS

ApoM/HDL-C and apoM/apoA1 ratios could be used as indicators for identification of DN from healthy people and from T2DM patients.

摘要

背景

2型糖尿病（T2DM）患者载脂蛋白M（apoM）浓度降低。apoM在肾小管上皮细胞中选择性表达。我们研究了糖尿病肾病（DN）患者血浆apoM浓度的变化以及apoM作为DN生物标志物的潜力。

方法

共纳入96例DN患者、100例年龄和性别匹配的糖尿病非肾病（非DN）患者以及110例健康对照者。所有T2DM患者根据尿白蛋白排泄量分为3组：正常白蛋白尿组（n = 100）、微量白蛋白尿组（n = 50）和大量白蛋白尿组（n = 46）。采用酶联免疫吸附测定法检测血浆apoM浓度。

结果

DN患者的血浆apoM浓度高于非DN患者（22.23±11.69对18.96±7.85ng/μl，P<0.05）。此外，微量白蛋白尿组的血浆apoM浓度高于正常白蛋白尿组（22.67±11.40对18.96±7.85ng/μl，P<0.05）。使用受试者工作特征（ROC）曲线分析apoM的曲线下面积（AUC）显示，血浆apoM浓度不能作为从健康人群中识别DN的指标（AUC = 0.478，P = 0.585），也不能作为从T2DM患者中识别DN的指标（AUC = 0.563，P = 0.125）。DN患者的apoM/HDL-C和apoM/apoA1比值高于健康对照者和非DN患者。apoM/HDL-C和apoM/apoA1比值可作为从健康人群中识别DN的指标（AUC分别为0.597，P = 0.016；AUC = 0.665，P = 0.000），也可作为从T2DM患者中识别DN的指标（AUC分别为0.580，P = 0.050；AUC = 0.601，P = 0.015）。