血清白介素-27浓度在2型糖尿病肾病早期诊断中的作用

Role of serum interleukin-27 concentration in early diagnosis of type 2 diabetic nephropathy

摘要:

目的：评估2型糖尿病及糖尿病肾病（diabetic nephropathy，DN）患者血清中白介素-27（interleukin27，IL-27）的水平及意义。方法：根据患者尿蛋白水平，将116例2型糖尿病（type 2 diabetes，T2D）患者分为糖尿病正常尿白蛋白组（DN0组）、早期糖尿病肾病组（DN1组）及临床糖尿病肾病组（DN2组），另外选取健康者作为对照组（H组），采用酶联免疫吸附试验（enzyme-linked immunosorbent assay，ELISA）检测各组IL-27水平；全自动生化仪检测超敏C反应蛋白（hypersensitive C-reactive protein，hs-CRP）、尿白蛋白/肌酐、血清肌酐、甘油三酯、总胆固醇水平；高效液相色谱检测法检测糖化血红蛋白水平；化学发光法检测C肽水平；并分析血清中IL-27浓度与上述指标的相关性。结果：与H组[546.200（411.600，639.250） pg/mL]相比，DN0组[788.200（594.500，1 010.950） pg/mL]患者血清中IL-27浓度明显升高，差异具有统计学意义（P=0.003）；DN1组[990.780（811.480，1 237.830） pg/mL]IL-27浓度较DN0浓度明显升高，差异具有统计学意义（P=0.028）；DN2组[1213.300（996.450，1 546.200） pg/mL] IL-27浓度较DN1浓度明显升高，差异具有统计学意义（P=0.037）。IL-27血清浓度与尿蛋白（r=0.580，P=0.000）、血肌酐（r=0.257，P=0.002）、糖化血红蛋（r=0.343，P=0.000)、血清hs-CRP（r=0.431，P=0.000）、空腹血糖浓度（r=0.334，P=0.000)呈正相关关系；与甘油三酯、总胆固醇、血清C肽无明显相关性（P>0.05）；IL-27作为DN患者血清标志物的潜能较hs-CRP作为诊断DN的潜能更大，两者联合诊断效能进一步增加。结论：IL-27的血清浓度与2型糖尿病患者DN的发展有关，IL-27可为DN患者早期诊断提供依据。

Abstract:

Objective：To assess the level and significance of interleukin-27（IL-27） in patients with type 2 diabetes mellitus （T2D） and diabetic nephropathy（DN）. Methods：A total of 116 patients with T2D were divided into diabetic normal urinary albumin group （DN0 group），early diabetic nephropathy group（DN1 group） and clinical diabetic nephropathy group（DN2 group） in accordance with urinary protein；healthy people were selected as the control group（H group）. Level of IL-27 was detected by enzyme-linked im－munosorbent assay（ELISA）. Hypersensitive C-reactive protein（hs-CRP），urinary albumin/creatinine，serum creatinine，triglyceride and total cholesterol were detected by automatic biochemical analyzer；glycosylated hemoglobin level was detected by high perfor－mance liquid chromatography；C-peptide level was detected by chemiluminescence；correlation between serum IL-27 concentration and those above indicators was analyzed. Results：IL-27 serum concentration of patients in the DN0 group[788.200（594.500，1010.950） pg/mL] was significantly higher than that in the H group[546.200（411.600，639.250） pg/mL]，with statistically significant difference（P=0.003）. IL-27 concentration in the DN1 group[990.780（811.480，1237.830） pg/mL] was significantly higher than that in the DN0 group，with statistically significant difference（P=0.028）. IL-27concentration in DN2 group[1213.300（996.450，1 546.200） pg/mL] was significantly higher than that in the DN1 group，with statistically significant difference（P=0.037）. IL-27 serum concentration had a positive relationship with urine protein（r=0.580，P=0.000），serum creatinine（r=0.257，P=0.002），glycosy－lated hemo-globin（r=0.343，P=0.000），serum hs-CRP（r=0.431，P=0.000） and fasting blood glucose concentration（r=0.334，P=0.000）；had no significant correlation with triglyceride，total cholesterol and serum C-peptide（P>0.05）. IL-27，as a serum marker of DN patients，had a higher potency than hs-CRP；combination of two markers was able to increase the diagnostic efficiency. Conclusion：Serum concentration of IL-27 is associated with the development of DN in patients with T2D. IL-27 may provide references to early diagnosis of DN patients.