【摘要】 目的探讨胰岛素样生长因子(IGF)及其结合蛋白(IGFBP)在2型糖尿病肾脏病变中的变化及其相关关系。方法2000-02～2003-05对广东省人民医院的130例(男52例、女78例),年龄在37～75岁2型糖尿病患者,观察了IGFs、IGFBPs、血脂、空腹和餐后2hC肽(CP0、CP120)等与血、尿α1和β2-微球蛋白(MG)的相关性,比较不同肾脏病变组间的IGFs和IGFBPs改变。结果多元逐步回归分析,血α1-MG主要相关预测因子为IGF-2、TC、年龄(r=0.492,P=0.0001);尿α1-MG为IGF-2、年龄(r=0.307,P=0.007);血β2-MG为IGFBP-1、HDL、年龄(r=0.528,P=0.0001);尿β2-MG为IGFBP-1、CP120、年龄(r=0.407,P=0.0001);血肌酐(Cr)为IGFBP-1、CP0、年龄(r=0.499,P=0.0001)。IGF-2和IGFBP-1在糖尿病肾病组显著升高[IGF-2:(889.48±65.94)μg/L对(711.57±28.73)μg/L,P=0.03;IGFBP-1:(94.91±17.48)μg/L对(54.81±5.04)μg/L,P=0.009]。结论2型糖尿病患者血清IGFBP-1、IGF-2水平与血、尿微球蛋白水平有密切的相关性,糖尿病肾病的IGFBP-1和IGF-2明显升高。糖尿病的胰岛功能改变、IGF与IGFBP系统以及脂代谢异常,与糖尿病肾病的发生、发展有关。更多还原

【Abstract】 Objective The aim of the present study was to assess the changes of IGF-1,IGF-2,IGFBP-1 and IGFBP-3 in diabetes nephropathy,the relationships between IGFs,IGFBPs and α₁-,β₂- microglobulin.Methods A total of 130 type-2 diabetic participants（male:52,female:78）aged 37⁷5 yeares in Guangdong Provincial People’s Hospital were enrolled from Feb.2000 to May 2003.Serum IGF-1,IGF-2,IGF binding protein 1（IGFBP-1）,IGFBP-3,creatinine（Cr）,cholesterol,triglycerides,HDL,LDL,apolipoprotein B100（apoB100）,apoA,HbA₁c,fasting and postprandial C-peptide,serum and urine α₁-MG and β₂-MG were measured.Patients were divided into clinical albuminuria（DN,n=24）,microalbuminuria（MA,n=40）,and normal（NOR,n=66）groups according sCr and urine Alb/Cr ratio.Results In multiple linear regression analysis,determinants of S α₁-MG were IGF-2 、TC and age（r=0.492,P=0.0001）;U α₁-MG were IGF-2、age（r=0.307,P=0.007）; S β₂-MG were IGFBP-1、HDL and age（r=0.528,P=0.0001）;U β₂-MG were IGFBP-1、CP120 and age（r=0.407,P=0.0001）;s-Cr were IGFBP-1、CP0 and age（r=0.499,P=0.0001）。Serum IGF-2 and IGFBP-1 were significantly increased in DN group[IGF-2:（889.48±65.94）μg/L vs （711.57±28.73）μg/L,P=0.03;IGFBP-1:（94.91±17.48）μg/L vs（54.81±5.04）μg/L,P=0.009].Conclusion Serum IGFBP-1 and IGF-2 are significantly increased in type 2 diabetes with nephropathy.The disorders of IGFs and lipid metabolism may contribute to the development of diabetic nephropathy.更多还原