2型糖尿病患者血清Dickkopf-1与蛋白尿之间的关系。
Relationship between serum Dickkopf-1 and albuminuria in patients with type 2 diabetes.
作者信息
Hou Ning-Ning, Kan Cheng-Xia, Huang Na, Liu Yong-Ping, Mao En-Wen, Ma Yu-Ting, Han Fang, Sun Hong-Xi, Sun Xiao-Dong
机构信息
Department of Endocrinology, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China.
Department of Pathology, Affiliated Hospital of Weifang Medical University, Weifang 261031, Shandong Province, China.
出版信息
World J Diabetes. 2021 Jan 15;12(1):47-55. doi: 10.4239/wjd.v12.i1.47.
BACKGROUND
Diabetic kidney disease is a microvascular complication of diabetes with complex pathogenesis. Wingless signaling-mediated renal fibrosis is associated with diabetic kidney disease. Dickkopf-1, a negative regulator of Wingless, has been proven to participate in renal fibrosis, glucose metabolism, and inflammation. However, whether serum Dickkopf-1 levels are associated with diabetic kidney disease remains unclear.
AIM
To assess the relationship between serum Dickkopf-1 levels and albuminuria in individuals with type 2 diabetes.
METHODS
Seventy-three type 2 diabetes patients and 24 healthy individuals were enrolled in this case-control study. Diabetic individuals were separated into normal albuminuria, microalbuminuria, and macroalbuminuria groups based on their urinary albumin/creatinine ratios (UACRs). Clinical characteristics and metabolic indices were recorded. Serum Dickkopf-1 levels were determined by enzyme-linked immunosorbent assay.
RESULTS
No significant difference in serum Dickkopf-1 levels was found between healthy individuals and the normal albuminuria group. However, the levels in the microalbuminuria group were significantly lower than those in the normal albuminuria group ( = 0.017), and those in the macroalbuminuria group were the lowest. Bivariate analysis revealed that serum Dickkopf-1 levels were positively correlated with hemoglobin A1c level ( = 0.368, < 0.01) and estimated glomerular filtration rate ( = 0.339, < 0.01), but negatively correlated with diabetes duration ( = -0.231, = 0.050), systolic blood pressure ( = -0.369, = 0.001), serum creatinine level ( = -0.325, < 0.01), and UACR ( = -0.459, < 0.01). Multiple and logistic regression showed that serum Dickkopf-1 levels were independently associated with UACR (odds ratio = 0.627, = 0.021).
CONCLUSION
Serum Dickkopf-1 levels are negatively associated with UACR. Lower serum Dickkopf-1 levels could be a critical risk factor for albuminuria in diabetes.
背景
糖尿病肾病是糖尿病的一种微血管并发症，其发病机制复杂。无翅信号介导的肾纤维化与糖尿病肾病相关。Dickkopf-1是无翅信号的负调节因子，已被证明参与肾纤维化、糖代谢和炎症反应。然而，血清Dickkopf-1水平是否与糖尿病肾病相关仍不清楚。
目的
评估2型糖尿病患者血清Dickkopf-1水平与蛋白尿之间的关系。
方法
本病例对照研究纳入了73例2型糖尿病患者和24例健康个体。根据尿白蛋白/肌酐比值（UACR）将糖尿病个体分为正常蛋白尿组、微量白蛋白尿组和大量白蛋白尿组。记录临床特征和代谢指标。采用酶联免疫吸附测定法测定血清Dickkopf-1水平。
结果
健康个体与正常蛋白尿组血清Dickkopf-1水平无显著差异。然而，微量白蛋白尿组的水平显著低于正常蛋白尿组（P = 0.017），大量白蛋白尿组的水平最低。双变量分析显示，血清Dickkopf-1水平与糖化血红蛋白水平呈正相关（r = 0.368，P < 0.01）和估计肾小球滤过率呈正相关（r = 0.339，P < 0.01），但与糖尿病病程呈负相关（r = -0.231，P = 0.050）、收缩压呈负相关（r = -0.369，P = 0.001）、血清肌酐水平呈负相关（r = -0.325，P < 0.01）和UACR呈负相关（r = -0.459，P < 0.01）。多元和逻辑回归显示，血清Dickkopf-1水平与UACR独立相关（比值比 = 0.627，P = 0.021）。
结论
血清Dickkopf-1水平与UACR呈负相关。较低的血清Dickkopf-1水平可能是糖尿病患者蛋白尿的关键危险因素。
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