The 2nd Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China.
Front Endocrinol (Lausanne). 2022 Apr 25;13:855616. doi: 10.3389/fendo.2022.855616. eCollection 2022.
Diabetic nephropathy (DN), one of the major complications of diabetes mellitus, is the major cause of end-stage renal failure that finally increases the risk of cardiovascular disease and mortality. The aim of this study is to explore the relationship between serum lipocalin-2 (LCN-2) levels and DN and carotid atherosclerotic plaque (CAP) in patients with type 2 diabetes mellitus (T2DM).
We have performed a prospective study of 749 T2DM patients with or without DN. Blood samples were collected and used to test serum LCN-2 levels, renal function, as well as biochemical parameters. CAP in these subjects was determined by ultrasonography.
In these 749 subjects with T2DM, an increased morbidity of CAP was observed in T2DM patients with DN as compared with those without this complication ( < 0.05). Interestingly, serum LCN-2 levels were significantly increased in T2DM patients with DN or CAP compared with T2DM alone [97.71 (71.49-130.13) 77.29 (58.83-115.05) ng/ml, < 0.001]. In addition, serum LCN-2 levels in T2DM patients with DN and CAP were significantly higher than that of T2DM patients with DN or CAP [131.37 (101.43-182.04) 97.71(71.49-130.13) ng/ml, < 0.001]. Furthermore, serum LCN-2 levels were positively correlated with hemoglobin A1c, systolic blood pressure, hypertension, CAP, and DN, as well as renal function factors including uric acid, creatinine, the estimated glomerular filtration rate, and urinary albumin-to-creatinine ratio, respectively ( < 0.05), but negatively correlated with HDL-c ( < 0.05). The multinomial logistic regression analysis showed that serum LCN-2 was independently associated with DN and CAP in patients with T2DM after the adjustment for risk factors ( < 0.001).
Early-stage renal damage is a risk factor associated with the incidence of CAP in patients with T2DM. Serum LCN-2 is significantly increased and associated with early-stage renal damage and the incidence of CAP in patients with T2DM.
糖尿病肾病（DN）是糖尿病的主要并发症之一，是终末期肾衰竭的主要原因，最终增加了心血管疾病和死亡率的风险。本研究旨在探讨 2 型糖尿病（T2DM）患者血清脂联素-2（LCN-2）水平与 DN 和颈动脉粥样硬化斑块（CAP）的关系。
我们进行了一项前瞻性研究，纳入了 749 例有或无 DN 的 T2DM 患者。采集血样，检测血清 LCN-2 水平、肾功能和生化参数。通过超声检查确定这些受试者的 CAP。
在这 749 例 T2DM 患者中，DN 患者的 CAP 发病率高于无此并发症的患者（<0.05）。有趣的是，与单纯 T2DM 相比，DN 或 CAP 的 T2DM 患者的血清 LCN-2 水平显著升高[97.71（71.49-130.13）ng/ml，<0.001]。此外，DN 和 CAP 的 T2DM 患者的血清 LCN-2 水平明显高于 DN 或 CAP 的 T2DM 患者[131.37（101.43-182.04）ng/ml，<0.001]。此外，血清 LCN-2 水平与血红蛋白 A1c、收缩压、高血压、CAP 和 DN 以及尿酸、肌酐、估计肾小球滤过率和尿白蛋白与肌酐比等肾功能因素呈正相关（<0.05），与 HDL-c 呈负相关（<0.05）。多变量逻辑回归分析显示，在校正了危险因素后，血清 LCN-2 与 T2DM 患者的 DN 和 CAP 独立相关（<0.001）。
早期肾损伤是 T2DM 患者 CAP 发病率的危险因素。血清 LCN-2 显著升高，并与 T2DM 患者的早期肾损伤和 CAP 发病率相关。
