The Relationship Between Serum C1q/TNF-related Protein-3 And Type2 Diabetic Nephropathy

Objectives:Through the study of the relationship of serum CTRP3 levels withinterleukin-6(IL-6),blood glucose,blood lipid and other related indicators in type 2 diabetic nephropathy patients with different renal function stages,to investigate the relationship between serum CTRP3 and type 2 diabetic nephropathy of different renal function.Methods:The healthy individuals with normal glucose tolerance fromMedical examination center were selected as normal control group(group NC,n=70),and the type 2 diabetic patients in line with the internationally accepted WHO diabetes expert committee(1999)proposed diagnostic criteria in Department of endocrinology were selected as type 2 diabetes mellitus group(group T2 DM,n=207).According to the urinary albumin excretion rate(UAER)on the basis of the Mogensen staging method,these subjects in type 2 diabetes mellitus group were divided into three sub-groups: simple type 2 diabetes mellitus group(ADM group,UAER <30mg/24h);early diabetic nephropathy group(EDN group,UAER 30~300mg/24h);clinical diabetic nephropathy group(LDN group: UAER ?300mg / 24h);Besides,according to the glomerular filtration rate(GFR)on the basis of guidelines established by the American kidney foundation,these subjects in type 2 diabetes mellitus group were divided into five sub-groups: Stage 1 chronic kidney disease group(group CKD1: GFR?90ml/min);stage 2 chronic kidney disease group(group CKD2,GFR 60~89ml/min);stage 3 chronic kidney disease group(group CKD3,GFR 30~59ml/min);stage 4 chronic kidney disease group(group CKD4,GFR 15~29ml/min);stage 5 chronic kidney disease group(CKD5 group: GFR < 15ml/min).The serum levels of CTRP3 and IL-6 in every subject was detected by ELISA method.The general parameters such as age,body weight,height and blood pressure were collected,and the fasting blood glucose(FPG),postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),Total cholesterol(TC),high density lipoprotein(HDL),low density lipoprotein(LDL),serum creatinine(SCr),Cystatin C(CysC),urea nitrogen(BUN),?2-microglobulin(?2-GM),UAER,C-reactive protein(CRP)and other indicators were measured,and finally analyze the difference of CTRP3 between normal control group and type 2 diabetes mellitus sub-groups and its correlation with the above indexes.Results:(1)Compared with NC group,type 2 diabetes mellitus group body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),FPG,2hPG,HOMA2-IR,HbA1 c,TG,TC,LDL,SCr,BUN,CysC,?2-GM,CRP,IL-6 were significantly increased,CTRP3,HDL,GFR were significantly decreased,All P<0.01;(2)The serum level of CTRP3(ng/ml): NC group was 381.80± 46.81,T2 DM group was 256.37±52.72,T2 DM group was significantly lower than NC group,P<0.01;the serum level of CTRP3 decreased with the increase of UAER: ADM group,EDN group and LDN group were 317.86±22.32,282.65±25.00,207.14±26.50,The comparison of each group was P< 0.01;the serum level of CTRP3 decreased with the decrease of GFR: CKD1 group,CKD2 group,CKD3 group,CKD4 group and CKD5 group were 304.83±27.32,279.17±46.19,239.73±46.57,220.24±38.28,209.66±32.02,The comparison of each group(except CKD4 group and CKD5 group)was P< 0.01;(3)Linear correlation analysis of CTRP3 and other variables: the serum levels of CTRP3 were negatively correlated with course of disease,BMI,SBP,FPG,2hPG,HbA1 c,TG,SCr,BUN,CysC,?2-GM,UAER,CRP and IL-6(P< 0.01);and negatively correlated with HOMA2-IR(P< 0.05);positively correlated with FCP,HDL and GFR(P< 0.01);furthermore multiple linear stepwise regression analysis showed that TG,IL-6,UAER and GFR were the influencedfactors of serum CTRP3.Conclusions:1.The level of serum CTRP3 in patients with type 2 diabetes is significantly lower than that in healthy controls.2.The level of serum CTRP3 is related to type 2 diabetic nephropathy,The level of serum CTRP3 in patients with type 2 diabetic nephropathy is decreased with the increase of UAER and the decrease of GFR.3.TG,IL-6,UAER,GFR are the influencing factors of serum CTRP3.