目的:分析糖尿病肾病(DN)患者血清血小板反应蛋白-1 (TSP-1)水平变化及与血脂和糖尿病有关指标的关系.方法:108例2型糖尿病(T2DM)患者,按其是否合并DN分为单纯T2DM组(T2DM组,n=52)和DN组(n=56),另选50例体检健康者为正常对照(对照组).各组均抽取空腹肘静脉血,检测血清TSP-1、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、血脂指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和血浆纤维蛋白原(Fib)水平;计算胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β).比较各指标在三组间的差异,分析TSP-1与其它相关指标的相关性,回归分析TSP-1的独立危险因素及TSP-1与DN的关系.结果:三组间血清TSP-1、FBG、HbA1c、LDL-C、血浆Fib水平及FINS、HOMA-IR、HOMA-β有统计学差异,且多数表现为对照组＜T2 DM组＜DN组.相关分析表明,TSP-1水平与FBG、HbA1c、LDL-C、Fib、FINS、HOMA-IR呈正相关,与HOMA-β呈负相关.多因素线性回归分析显示Fib、HbA1C、FINS、HOMA-β是血清TSP-1的独立影响因素,TSP-1与DN的发生有关(β=0.014,P＜0.05).结论:TSP-1水平升高与DN发生相关,下调TSP-1表达和管控TSP-1影响因素,对防治DN有重要意义.%Objective:To analysis the level changes and the relationship between the blood fat and indexes related to diabetes mellitus of serum thrombospondin-1 (TSP-1) in patients with diabetic nephropathy (DN).Method:108 T2DM patients according to whether complicated with DN were divided into T2DM group (n=52) and DN group (n=56),and 50 normal healthy persons for the normal control group (the control group).Fasting venous blood was collected in each group.The TSP-1 and other clinical indicators were detected.The steady-state model was used to account for the indexes of insulin resistance(HOMA-IR)and islet beta cell function index (HOMA-β).To compare the differences between the three groups,analysis of the correlation between TSP-1 and other related indicators,and using regression analysis to evaluate the independent risk factors TSP-1 and the relationship between the TSP-1 with DN.Results:There was significant difference in serum TSP-1,FBG,HbA1C,LDL-C,Fib,FINS,HOMA-IR level among the three group,and most performance as the control group ＜T2DM group ＜DN group.Correlation analysis showed that TSP-1 level was positively correlated with FBG,HbA1C,LDL-C,Fib,FINS,HO-MA-IR,and negatively correlated with HOMA-β.Multivariate linear regression analysis showed that Fib,HbA1C,FINS,HOMA-β were independent factors of serum TSP-1.TSP-1 was associated with diabetic nephropathy (β=0.014,P＜0.05).Conclusion:The level of TSP-1 was associated with DN.Down regulation of TSP-1 expression and control the influencing factors of TSP-1 are of great significance to the prevention and treatment of DN.
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