| Objective:To investigate the associations of albuminuria with serum SIRT1 and NF-?Bp65 in patients with T2DM and diabetic nephropathy?DN?.Methods:From December 2018 to October 2019,a total of 107 cases with type 2 diabe tes mellitus and diabetic nephropathy were enrolled from First Hospital of Shanxi Medical University.30 healthy examiners were served as control group during the same period?group C,14 males;16 females;the average age of the group was 53.67±11.69 years?.Collect the general data and laboratory indicators of all the subjects.According to Urinary albumin tocreatinine ratio?ACR?,the cases were categorized into 3 grou ps:normoalbuminuric cases?D1,n=31,ACR<30mg/g?,microalbuminuric cases?D2,n=35,ACR30-300mg/g?,and macroalbuminuric cases?D3,n=41,ACR>300 mg/g?.The gender,age,BMI,duration of type 2 diabetes mellitus,fasting blood glucose,glyca ted hemoglobin,total Cholesterol,triglyceride,high-density lipoprotein cholesterol,low Density lipoprotein cholesterol,blood uric acid,serum creatinine,blood urea nitrogen,Urinary albumin tocreatinine ratio,estimated glomerular filtration rate,24-hour proteinuria,sirt1 and nf-?bp65 were recorded.The estimated GFR calculated by Modification o f Diet in Renal Disease?MDRD?equation,eGFR=186×?Scr?-1.154×?age in yea rs?-0.203?×0.742 for female patients?.Serum sirt1 and nf-?bp65 levels were measure d by ELISA.The collected data were analyzed by statistics.The correlation between ACR level and clinical data including sirt1 and nf-?bp65 parameters were evaluated by Spearman's method.Logistic regression analysis was performed to assess independe nt risk factors for diabetic nephropathy.Results:1.Comparisons of general information:There were no statistically significant differences in age,sex and BMI between T2DM and control group?P>0.05?.In T2DM,diabetes duration had an increasing trend,but it was not statistically significant?P>0.05?.2.Comparisons of clinical characteristics:Pairwise comparison between the four groups were statistically significant for glycated hemoglobin and triglycerides?P<0.05?.There were no statistically significant differences in serum uric acid and blood urea nitrogen expression levels in four groups?P>0.05?.There was significant difference in fasting blood glucose among the four groups.The results of further pairwise comparison showed that the levels of fasting blood glucose in D1,D2 and D3 groups were higher than those in C group?P<0.05?,and those in D2 and D3 groups were higher than those in D1 group?P<0.05?.There was significant difference in total cholesterol among the four groups.The results of further pairwise comparison showed that the total cholesterol in D1,D2 and D3 groups was higher than that in C group?P<0.05?,and that in D3 group was higher than that in D1 and D2 groups?P<0.05?.HDL-C was significantly higher in group D1,D2 and D3 than that in group C,and that in group D3 was higher than that in group D2?P<0.05?.There was significant difference in LDL-C among the four groups.The results of further pairwise comparison showed that group D1 and D3were higher than group C,group D2 and D3 were higher than group D1,and group D3was higher than group D2?P<0.05?.There was significant difference in serum creatinine among the four groups.Further pairwise comparison showed that the level of creatinine in D3 group was significantly higher than that in C,D1 and D2 groups?P<0.05?.There was significant difference in eGFR among the four groups.Further pairwise comparison showed that group C,D1 and D2 were significantly higher than group D3?P<0.05?.There was significant difference in ACR among the four groups.Further pairwise comparison showed that the level of D3 group was significantly higher than that of C,D1and D2 groups?P<0.05?,and that of D2 group was significantly higher than that of C and D1 groups?P<0.05?.There was significant difference in 24HP among the four groups.Further pairwise comparison showed that the level of D3 group was higher than that of D2 and D1 groups?P<0.05?.3.Comparison of serum SIRT1 and NF-?Bp65 levels in each group:The levels of Sirtl and NF-?Bp65 in four groups were significantly different?P<0.05?.The level of Sirtl in C,D1,D2 and D3 groups decreased gradually,and the level of NF-?Bp65 gradually increased in C,D1,D2 and D3 groups?P<0.05?.4.The correlation between ACR and clinical indexes,SIRT1 and NF-?Bp65:the results of Spearman correlation analysis showed that ACR was positively correlated with fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,LDL-C,serum creatinine,24-hour proteinuria and NF-?Bp65,but negatively correlated with HDL-C,eGFR and Sirt1,and the differences were statistically significant?P<0.05?.5.Multivariate Logistic regression analysis:the occurrence of diabetic nephropathy was taken as dependent variable,and fasting blood glucose,glycosylated hemoglobin,total cholesterol,triglyceride,HDL-C,LDL-C,BUN,serum creatinine,eGFR,Sirtl and NF-?Bp65 were analyzed as independent variables.The results showed that the level of serum Sirtl decreased,while the levels of glycosylated hemoglobin,triglyceride and NF-?Bp65 increased were independent influencing factors of DN?P<0.05?.Conclusion:Serum SIRT1 levels are reduced and NF-?Bp65 levels are increased in patients with DN;serum SIRT1 and NF-?Bp65 levels are closely related to the degree of albuminuria;decreased serum SIRTl levels and increased NF-?Bp65 levels are independent risk factors for the occurrence of DN. |
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