Bulum Tomislav, Vučić Lovrenčić Marijana, Tomić Martina, Vučković-Rebrina Sandra, Roso Vinko, Kolarić Branko, Vuksan Vladimir, Duvnjak Lea
Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia; Medical School, University of Zagreb, Zagreb, Croatia.
Clinical Department of Medical Biochemistry and Laboratory Medicine, Merkur University Hospital, Zagreb, Croatia; Scientific Research Unit, Merkur University Hospital, Zagreb, Croatia.
Diabetes Metab Syndr. 2019 Jan-Feb;13(1):496-499. doi: 10.1016/j.dsx.2018.11.001. Epub 2018 Nov 3.
Recent studies have implicated possible contribution of adipocytokines in development and progression of microvascular complications in patients with type 1 diabetes (T1DM). The aim of our study was to investigate relationship between adipocytokines, namely leptin, resistin, adiponectin and dipeptidyl peptidase-4 (DPP-4) activity, with albuminuria in T1DM.
This study included 202 T1DM without or with incipient microvascular complications. Urinary albumin excretion rate (UAE) was measured from at least two 24-h urine samples. Serum DPP-4 activity was measured by a colorimetric assay, and the level of adiponectin, leptin, and resistin was determined by the ELISA method.
Serum DPP-4 activity and adiponectin were significantly higher in patients with normoalbuminuria compared to patients with microalbuminuria (47 vs 36 U/L, and 10.9 vs 7.3 μg/mL, respectively, p ≤ 0.02). In multivariate logistic regression analysis adiponectin and serum DPP-4 activity were significantly associated with risk of microalbuminuria in our subjects (p ≤ 0.04), with odds ratios of 0.72-0.99. However, after adjustment for age, sex, HbA1c, duration of diabetes and BMI, only serum DPP-4 activity was significantly associated with risk of microalbuminuria (p = 0.008).
The results of our study suggest that serum DPP-4 activity is lower in T1DM with microalbuminuria. Prospective studies are warranted to evaluate the relationship between serum DPP-4 activity and progression and development of albuminuria and nephropathy in T1DM.
近期研究表明，脂肪细胞因子可能在1型糖尿病（T1DM）患者微血管并发症的发生和发展中起作用。本研究的目的是探讨脂肪细胞因子，即瘦素、抵抗素、脂联素和二肽基肽酶-4（DPP-4）活性与T1DM患者蛋白尿之间的关系。
本研究纳入了202例无或有早期微血管并发症的T1DM患者。从至少两份24小时尿液样本中测量尿白蛋白排泄率（UAE）。采用比色法测定血清DPP-4活性，采用酶联免疫吸附测定法测定脂联素、瘦素和抵抗素水平。
与微量白蛋白尿患者相比，正常白蛋白尿患者的血清DPP-4活性和脂联素水平显著更高（分别为47 vs 36 U/L和10.9 vs 7.3 μg/mL，p≤0.02）。在多因素逻辑回归分析中，脂联素和血清DPP-4活性与本研究对象微量白蛋白尿的风险显著相关（p≤0.04），比值比为0.72 - 0.99。然而，在调整年龄、性别、糖化血红蛋白、糖尿病病程和体重指数后，只有血清DPP-4活性与微量白蛋白尿的风险显著相关（p = 0.008）。
我们的研究结果表明，伴有微量白蛋白尿的T1DM患者血清DPP-4活性较低。有必要进行前瞻性研究，以评估血清DPP-4活性与T1DM患者蛋白尿和肾病的进展及发生之间的关系。
