Correlation Study Of Combined Detection Of Serum Prealbumin,a-L-fucosidase, Bilirubin With Glycometabolism, Diabetic Nephropathy In Patients With Type2Diabets

In recent years, many scholars believe that, type2diabetic mellitus (T2DM) is a kind of natural immunity and low-grade inflammation in disease. High blood sugar is a secrete strong stimulating factor of inflammatory cytokines to stimulate the inflammatory cells. Prealbumin (PA) is considered to be an acute phase protein, exacerbation of PA reduced gradually with inflammation. Hyperglycemia can activates the polyol bypass system, be carbohydrate complex fucosylated involved in the adhesion between cell and cell inflammatory reaction, A-L-fucosidase (AFU) are also involved in the inflammatory reaction process--AFU could catalyze and hydrolysis the L-fucoseof of these sugars and complex, then AFU is thought to be a immune regulatory enzyme that has not been recognized which play a role in the late stage of the inflammatory response. As everyone knows, the oxidative stress play an important role in the development of diabetes and its complications. Recent studies show that, bilirubin is also an important member of the endogenous antioxidant system of in the human body, the body’s antioxidant capacity also decreased along with the decreased serum bilirubin level.In this study, by detection the serum prealbumin、bilirubin, bilirubin, a-L- fucosidase, urinary albumin levels and fasting blood glucose, glycosylated hemoglobin levels of T2DM patients and healthy controls, to investigate the relevance among serum albumin, bilirubin, a-L-fucosidase levels、glucose control levels and diabetic nephropathy in T2DM patients.ObjectiveTo investigate relationship between the levels of serum prealbumin (PA), bilirubin (BIL), a-L-fucosidase (AFU) and blood glucose control in type2diabetic mellitus (T2DM) patients, and to explore the relationship between the levels of serum prealbumin, bilirubin, a-L-fucosidase and diabetic nephropathy.Objects and Methods1.120T2DM patients(group DM) will be further divided into simple diabetic group (group NDN,45cases) and diabetic nephropathy group(group DN,75cases) according to the patient24hours urinary micro albumin excretion rate (mALB).2.60healthy people were selected as the healthy control group (control group).3. All patients were calculated the body mass index (BMI)、tested fasting liver function (ALT、AST)、fasting serum glucose (FPG)、glycosylated hemoglobin (HbA1c)、fasting serum bilirubin (TBIL、DBIL、IBIL)、fasting serum prealbumin (PA)、fasting serum a-L-fucosidase (AFU)、left24hours urine to samples urine micro albumin quantitative(mALB).4. Then to correlation analysis between PA、AFU、BIL、HbA1c、mALB of the DN group and NDN group.5. All statistical analysis was completed using Origin Pro v8.0software. The normal measurement data with the mean standard deviation (x±s) said, The comparison between two groups using t test, two two compard with analysis of variance. Analysis of correlation between two variables, using linear analysis, set moment correlation coefficient pearson (correlation coefficient) to describe the relationship between them. P<0.05says there are meaningful differences between two groups. P<0.01had a significant difference.Results1. AFU、mALB of DM group was significantly higher than the control group, while PA、bilirubin decreased, there was significant difference (P<0.05). AFU、 mALB of DN group than NDN group increased, while PA、bilirubin decreased, there was significant difference (P<0.01).2. To analyses AFU、PA、bilirubin of the NDN group and DN group,and glycosylated hemoglobin (HbAlc) levels、mALB with linear analysis. the results showed that, AFU and HbAlc of the two groups were positively correlated, yet PA、 bilirubin are negatively correlated with HbA1c. In group DN, AFU and urinary micro albumin were positively correlated (group NDN:r=0.28871, P=0.00138; group DN:r=0.66536, P=0.00743), PA and bilirubin were negatively related to urinary micro albumin. While in NDN group, AFU、PA and bilirubin have no obvious correlation with urinary micro albumin.3. In each group (T2DM group, NDN group, DN group), PA, AFU, bilirubin were performed Pearson correlation analysis shows:there is a linear relationship between the three, the positive correlation between PA and bilirubin, there was a negative correlation between the former two and AFU.ConclusionAn elevated AFU level、reduced bilirubin and PA levels in patients with diabetes mellitus, may be related to the poor glucose control and development of diabetic nephropathy.