The Association Between Apelin And Urinary Albumin Excretion Rate In Obses Type 2 Diabetes Mellitus

ObjectiveTo investigate the relationship between the level of Apelin in serum and urinary albumin excretion rate (UAER) in obses type 2 diabetes mellitus (T2DM), and to explore the role of Apelin in the development of diabetic nephropathy and to provide the clue and evidence of early diagnosis and treatment in diabetic nephropathy.MethodAccording to the criterion,30 healthy persons (male 15, female 15) that got checkup in Qingdao Municipal Hospital medical checkup center and 90 inpatients (male 44, female 46) in the Department of Endocrinology of Qingdao Municipal Hospital from June 2009 to December 2009 were divided into three groups and 120 cases in total for subjects. Groups were healthy control group, T2DM normal albuminuria group, T2DM microalbuminuria group and T2DM macroalbuminuria group,30 persons in each group. Blood pressure was measured, BMI was calculated, blood were taken to detect FPG, FINS, CHO, TG, LDL, HDL and HbAlc,24h urine were taken for UAER detection. With insulin resistance index (HOMA-IR) to assess insulin resistance.Apelin levels in patient blood serum were assayed by ELISA.Results①There were no significant differences between healthy controls group, T2DM normal albuminuria group, T2DM microalbuminuria group, T2DM group macroalbu-minuria group in the factors of age and sex (P> 0.05). Compared to healthy control group, the level of SBP,DBP, lnHOMA-IR, TG, CHO, LDL, HbAlc were higher and HDL was lower in obses type 2 diabetes mellitus.The blood serum Apelin levels were increased from the from the normal control group, T2DM normal protein urinary Group, T2DM microalbuminuria group to T2DM macroalbuminuria group (368.06±32.58 ng/L, 424.37±43.14 ng/L,462.73±57.46 ng/L,479.38±56.99 ng/L), there were significant differences between groups (P<0.05).②Apelin was positively correlated with UAER (r=0.318, P<0.01), SBP(r=0.219,P<0.05), BMI(r=0.298,P<0.01), FPG(r=0.284,P<0.01), FINS (r=0.212,P<0.05), lnHOMA-IR (r=0.292,P<0.05), HbAlc (r=0.291,P<0.01), CHO (r=0.340,P<0.01), TG (r=0.199,P<0.05),LDL (r=0.225,P<0.05) negatively correlated with HDL(r=-0.179,P<0.05) and no obviously correlation with age,gender and DSP (P> 0.05).③CHO (β=0.171,P<0.05),lnHOMA-IR(β=0.202,P<0.05),UAER (β=0.179,P<0.05), BMI (β=0.194,P<0.05) were the independent factors of the serum Apelin by stepwise multiple linear regression analysis.Conclusions1.Apelin levels in obses T2DM patients are significantly increased and increase gradually with the development of the severity of albuminuria, Apelin may be involved in the occurrence and development of diabetic nephropathy.2.CHO, UAER, lnHOMA-IR, BMI are the independent factors of the serum Apelin levels.3.Apelin is significantly correlated with lnHOMA-IR, Serum levels of Apelin may predict a sensitive indicator of Insulin Resistance.