阿片肽：一种用于早期检测2型糖尿病患者糖尿病肾病的潜在新型血清生物标志物。
Apelin: A potential novel serum biomarker for early detection of diabetic nephropathy in patients with type 2 diabetes.
作者信息
Demirpence Mustafa, Yilmaz Hamiyet, Colak Ayfer, Pamuk Baris Onder, Karakoyun Inanc, Basok Banu
机构信息
Department of Endocrinology and Metabolism, Tepecik Training and Research Hospital, Izmir, Turkey.
Department of Clinical Biochemistry, Tepecik Training and Research Hospital, Izmir, Turkey.
出版信息
North Clin Istanb. 2018 Aug 14;6(2):151-155. doi: 10.14744/nci.2018.62134. eCollection 2019.
OBJECTIVE
Diabetic nephropathy (DN) is the major cause of chronic renal failure, and proteinuria is an independent risk factor for the end stage renal disease. The random urine protein: creatinine ratio (P:C ratio) can accurately predict the amount of 24-hour urinary protein excretion. Apelin is thought to be associated with endothelial dysfunction, angiogenesis, and inflammation. This study investigated the apelin concentration and its association with the urine P:C ratio, and metabolic parameters in subjects with and without type 2 diabetes mellitus (T2D).
METHODS
This study involved 86 subjects: 56 with newly diagnosed and untreated T2D and 30 non-diabetic controls. All subjects underwent a complete clinical examination that included anthropometric and laboratory measurements.
RESULTS
Twenty-four males and sixty-two females participated in this study, and their mean age was 52.27±11.34 years. There were no differences in age, thyrotropin-stimulating hormone (TSH), creatinine clearance, and apelin levels between groups. As expected, fasting plasma glucose, weight, body mass index, and HbA1C were higher in T2D subjects (p=0.001, p=0.02, p=0.03, and p=0.001, respectively). Although apelin levels were higher in the control group, the differences were not statistically significant (p=0.93). The P:C ratio levels were lower in the control group, and the differences were statistically significant (p=0.006). A Spearman correlation analysis revealed that serum apelin levels were not correlated with the urine P:C ratio.
CONCLUSION
Our study demonstrates that T2D is associated with decreased serum apelin levels and increased urine P:C ratios compared to those in non-diabetic subjects. This association may depend on impaired glucose homeostasis. Our results show that the serum apelin levels were not correlated with the urine protein: creatinine ratio and provide further evidence regarding the relationship between apelin and DN.
目的
糖尿病肾病（DN）是慢性肾衰竭的主要病因，蛋白尿是终末期肾病的独立危险因素。随机尿蛋白与肌酐比值（P:C比值）可准确预测24小时尿蛋白排泄量。阿片肽被认为与内皮功能障碍、血管生成和炎症有关。本研究调查了2型糖尿病（T2D）患者和非T2D患者的阿片肽浓度及其与尿P:C比值和代谢参数的关系。
方法
本研究纳入86名受试者：56名新诊断且未接受治疗的T2D患者和30名非糖尿病对照者。所有受试者均接受了包括人体测量和实验室检测在内的全面临床检查。
结果
24名男性和62名女性参与了本研究，他们的平均年龄为52.27±11.34岁。两组之间在年龄、促甲状腺激素（TSH）、肌酐清除率和阿片肽水平方面无差异。正如预期的那样，T2D患者的空腹血糖、体重、体重指数和糖化血红蛋白水平更高（分别为p = 0.001、p = 0.02、p = 0.03和p = 0.001）。虽然对照组的阿片肽水平较高，但差异无统计学意义（p = 0.93）。对照组的P:C比值水平较低，差异有统计学意义（p = 0.006）。Spearman相关性分析显示，血清阿片肽水平与尿P:C比值无相关性。
结论
我们的研究表明，与非糖尿病受试者相比，T2D与血清阿片肽水平降低和尿P:C比值升高有关。这种关联可能取决于葡萄糖稳态受损。我们的结果表明，血清阿片肽水平与尿蛋白与肌酐比值无相关性，并为阿片肽与DN之间的关系提供了进一步的证据。
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