The Relationship Between Serum Betatrophin Levers And Diabetic Nephropathy In Type 2 Diabetic Patients And Its Significance

Objective:This study measured serum betatrophin between normal control,normal albuminuria,microalbuminuria and macroalbuminuria,and explored the correlations between its serum levels and DN,and provide useful information for early diagnosis of DN.Methods:A total of 64 subjects were enrolled in this study.The participants were divided into T2 DM patients(n=48)and normal control subjects(n=16).The T2 DM group was divided into normal albuminuria group(16 cases),microalbuminuria group(16 cases)and macroalbuminuria group(16 cases)based on(UACR)≥30mg/g and(UACR)≥300mg/g.Anthropometric characteristics were measured.Glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),fasting insulin(FINS),lipids,high-sensitivity C-reactive protein(HsCRP),serum creatinine(Cr),glomerular filtration rate(GFR)and other biochemical parameters were also detected.The MAU of T2 DM patients were determined by immunoturbidimertry,and fasting serum betatrophin concentrations were measured by enzyme-linked immunosorbent assay(ELISA).Results:(1)Compared with the normal control group,waistline,SBD,FPG,FINS,TG,TC,LDL,CR,BUN and UACR in T2 DM group were significantly increased(P<0.05),while HDL and GFR were decreased(P<0.05).Compared with normal albuminuria group,waistline,TG,Cr,and BUN in macroalbuminuria group were significantly incre ased,while GFR was decreased(P<0.05).Compared with microalbuminuria group,FINS,TG,FCP,Cr and BUN in macroalbuminuria group were significantly increased,while GFR was decreased(P<0.05).(2)Serum betatrophin levels in T2 DM patients were significantly higher than in normal control subjects(P<0.05).Serum betatrophin levels in abnormal albuminuria patients were also significantly higher than in normal albuminuria(P<0.05).Serum betatrophin levels in macroalbuminuria patients were also significantly higher than in microalbuminuria patients(P<0.05).(3)Serum betatrophin levels in normal control patients positively correlated with Cr and UACR(P<0.05),but negatively with SBP(P<0.05).Serum betatrophin levels in normal albuminuria patients positively correlated with BMI,TC,TG and UACR(P<0.05).Serum betatrophin levels in microalbuminuria patients positively correlated with TG and HsCRP(P<0.05).Serum betatrophin levels in macroalbuminuria patients positively correlated with TG,HsCRP,Cr and BUN(P<0.05),but negatively with Hb A1 C and GFR(P<0.05).Serum betatrophin levels in T2 DM patients positively correlated with FCP,TC,TG,HsCRP,UACR,Cr and BUN(P<0.05),but negatively with GFR(P<0.05).(4)Multivariate stepwise regression models were fit for betatrophin as a dependent variable,other indicators as independent variables to demonstrate the relative contribution to the outcome ones.The results showed that Cr(B=2.923,P<0.001),TG(B=59.670,P=0.004)and HbA1c(B=26.199,P=0.006)were related factors influencing serum betatrophin level(R2=0.717,P<0.001).(5)Ordinal ploytomous logistic regression analysis showed that circulating betatrophin was significantly associated with UACR.Conclusion:(1)Serum betatrophin levels were significantly increased in T2 DM with DN.As the DN gets worse,serum betatrophin levels gradually increase.(2)Serum betatrophin levels were associated with UACR positively.The trend in the presence of DN was more apparent in higher serum betatrophin tertile group.(3)High levels of serum betatrophin were the risk factor of proteinuria,which may play an important role in the pathogenesis of DN.