|国家科技期刊平台
首页|期刊导航|安徽医科大学学报|血清C型凝集素结构域家族11成员A在糖尿病肾脏病进展中的变化及在骨代谢评估中的意义

血清C型凝集素结构域家族11成员A在糖尿病肾脏病进展中的变化及在骨代谢评估中的意义OA北大核心CSTPCD

Changes of serum Clec11a in the progression of diabetic kidney disease and its significance in bone metabolism assessment

中文摘要英文摘要

目的 分析血清C型凝集素结构域家族11成员A(Clec11a)在糖尿病肾脏病(DKD)进展中的变化,评估其在DKD患者骨代谢评价中的价值.方法 收集184例2型糖尿病(T2DM)患者临床资料并检测外周血Clec11a水平,根据尿白蛋白肌酐比(UACR)将纳入的患者分为三组:无蛋白尿组(UACR<30 mg/g,76例)、微量蛋白尿组(UACR 30~300 mg/g,72 例)和大量蛋白尿组(UACR>300 mg/g,36例).另选取同期体检健康者50例为正常对照组.比较各组患者的一般资料、骨密度(BMD)、骨代谢指标,分析非糖尿病、不同分期DKD患者血清Clec11a水平及其他骨代谢指标,评估UACR与Clec11a及其他骨代谢指标之间的相关性.结果 T2DM各亚组Clec11a水平及估测肾小球滤过率(eGFR)均低于正常对照组(P<0.05).在T2DM各亚组间比较,随着UACR上升,Clec11a水平及eGFR逐渐降低,差异有统计学意义(P<0.05).微量蛋白尿组股骨颈BMD、Clec11a水平低于无蛋白尿组(P<0.05);大量蛋白尿组腰椎BMD、Clec11a水平低于微量蛋白尿组(P<0.05).而骨代谢指标如25羟维生素D[25(OH)D]、骨钙素N端中分子片段、I型前胶原氨基端前肽、甲状旁腺素、β胶原降解产物,微量蛋白尿组与无蛋白尿组之间差异无统计学意义.T2DM患者BMD、25(OH)D、Clec11a水平与UACR水平呈负相关(P<0.05),其中Clec11a与UACR相关性最强.结论 T2DM患者血清Clec11a水平显著降低,且随着UACR的上升逐渐降低;与其他骨代谢指标比较,Clec11a与UACR间呈较强的负相关性.定期检测DKD患者血清Clec11a含量有助于早期识别骨量丢失.

Objective To analyze the changes of serum C-type lectin domain family 11 member A(Clec11a)in the progression of diabetic kidney disease(DKD)and evaluate its value in bone metabolism.Methods The clini-cal data of 184 patients with type 2 diabetes(T2DM)were collected and serum Clec11a levels were detected.Ac-cording to the UACR,patients were divided into non-albuminuria group of 76 cases,microalbuminuria group of 72 cases and macroalbuminuria group of 36 cases.In the same period,50 healthy subjects were selected as control group.The general clinic data,bone mineral density and bone metabolism indexes of all groups were measured.The correlation between Clec11a level and bone metabolism indexes of DKD patients was analyzed.Results Levels of Clec11a and eGFR in all T2DM subgroups were significantly lower than those in normal control group(P<0.05).Levels of Clec11a and eGFR in T2DM subgroups significantly decreased with the increasement of UACR(P<0.05).Bone mineral density(BMD)of neck of femur and Clec11a levels in microalbuminuria group were lower than those in non-albuminuria group(P<0.05).The levels of Clec11a and BMD of lumbar vertebra in macroalbu-minuria group were lower than those in microalbuminuria group(P<0.05).Bone metabolism indexes such as 25 hydroxyvitamin D[25(OH)D],N-terminal fragment of osteocalcin,amino terminal peptide of type Ⅰ procollagen,parathyroid hormone,and β collagen degradation products were not significantly different between microalbuminuria group and non-albuminuria group.BMD,25(OH)D and Clec11a levels were negatively correlated with UACR levels(P<0.05).Clec11a had the strongest correlation with UACR.Conclusion Serum Clec11a levels in T2DM pa-tients significantly decreased with the increasement of UACR.Compared with other bone metabolism indexes,Clec11a showed a stronger negative correlation with UACR.Regular detection of serum Clec11a levels for DKD pa-tients is conducive to identify bone loss early.

石瑞峰;唐明娜;邓大同

安徽医科大学第一附属医院内分泌科,合肥 230022

临床医学

糖尿病肾脏病骨密度Clec11a尿白蛋白肌酐比

diabetic kidney diseasebone mineral densityClec11aurinary albumin creatinine ratio

《安徽医科大学学报》 2024 (007)

1280-1284 / 5

国家自然科学基金(编号:82100845)

10.19405/j.cnki.issn1000-1492.2024.07.027

评论