| Objective:This study was to investigate the changes of serum irisin and chemerin standards in patients with type 2 diabetic kidney disease(T2DKD)and their contributing elements,so as to provide a new way for the forecast and diagnosis of T2 DKD.Methods:1.Research samples: 30 healthy subjects(NGT group),25 patients with type 2diabetes(T2DM group)and 26 patients with type 2 diabetic kidney disease(T2DKD group)who were admitted to the Second Hospital of Shanxi Medical University from March 2019 to September 2019 were choosed.2.Common data collection: common data of the research samples were registerred,such as gender,age,weight,height,diastolic blood pressure(DBP)and systolic blood pressure(SBP).3.Clinical indicators collection: Blood glucose related indicators included: fasting blood glucose(FPG),2h postprandial blood glucose(2h PG)and glycosylated hemoglobin A1c(HbA1c).Insulin related indexes included: insulin hypersensitivity(FINs)and C peptide.The lipid related indexes included: high density lipoprotein(HDL),low density lipoprotein(LDL),triglyceride(TG),total cholesterol(TC),apolipoprotein A(Apo A),apolipoprotein B(Apo B),apolipoprotein E(Apo E)and lipoprotein-α(LPa).Renal function related indicators included: serum creatinine,urea nitrogen,urinary microalbumin(AIb),urinary microalbumin/urinary creatinine(ACR).4.Body mass index(BMI),islet β-cell function index(HOMA-β)and insulin resistance index(HOMA-IR)were calculated.Results:1.Comparison of common data among the three groups: There are no statistically significant differences in gender,age,BMI and DBP among the three groups(P>0.05);compared with NGT group and T2 DM group,SBP in T2 DKD group is significantly increased,and the difference is statistically significant(P<0.05).2.Comparison of basic clinical indexes among the three groups: There are no statistically significant differences in C-peptide,TC,Apo A,Apo B and LPa among the three groups(P>0.05).Compared with NGT group,the levels of FPG,2 h PG,HbA1c,FINs,HOMA-IR,LDL,TG,Apo E and AIb in T2 DM group are significantly increased,while the levels of HOMA-β and HDL are significantly decreased,and the differences are statistically significant(P<0.05);compared with NGT group,the levels of FPG,2 h PG,HbA1c,FINs,HOMA-IR,LDL,TG,Apo E,serum creatinine,urea nitrogen,AIb and ACR in T2 DKD group are significantly increased,while the levels of HOMA-β and HDL are significantly decreased,and the differences are statistically significant(P<0.05);compared with T2 DM group,the levels of FINs,serum creatinine,AIb and ACR are significantly increased in T2 DKD group,and the differences are statistically significant(P<0.05).3.Comparison of irisin and chemerin among the three groups: Compared with NGT group,the level of irisin in T2 DM group and T2 DKD group is significantly decreased while the level of chemerin is significantly increased,and the differences are statistically significant(P<0.05);compared with T2 DM group,the level of irisin in T2 DKD group is significantly decreased and the level of chemerin is significantly increased,and the differences are statistically significant(P<0.05).4.Correlation analysis of serum adipocytokine irisin with various indexes:Irisin is positively related with HDL and HOMA-β(P<0.05),and negatively related with FPG,2 h PG,HbA1c,FINs,HOMA-IR,LDL,serum creatinine,urea nitrogen,AIb and ACR(P<0.05).5.Correlation analysis of serum adipocytokine chemerin with various indexes:Chemerin is positively related with FPG,2 h PG,HbA1c,FINs,HOMA-IR,LDL,serum creatinine,urea nitrogen,AIb and ACR(P<0.05),and negatively related with HDL and HOMA-β(P<0.05).6.Serum adipocytokine irisin is negatively related with chemerin(P<0.05).7.Multiple stepwise regression analysis showed that SBP,HbA1c,C-peptide and AIb are independent contributing elements for irisin,while HbA1c,AIb and ACR are independent contributing elements for chemerin.Conclusion:1.Compared with NGT group,the level of irisin in T2 DM group and T2 DKD group are significantly decreased,while the level of chemerin are significantly increased;compared with T2 DM group,the level of irisin in T2 DKD group is significantly decreased,while the level of chemerin is significantly increased.These are suggested that serum adipocytokines irisin and chemerin may be related to T2 DKD.2.Serum adipocytokine irisin is positively related with HDL and HOMA-β,and negatively related with FPG,HbA1c,FINS,HOMA-IR,LDL,serum creatinine,urea nitrogen,AIb and ACR.Serum adipocytokine chemerin is positively related with FPG,HbA1c,FINS,HOMA-IR,LDL,serum creatinine,urea nitrogen,AIb,ACR,and negatively related with HDL and HOMA-β.Serum adipocytokine irisin is negatively related with chemerin.These results suggest that both irisin and chemerin are related to the levels of blood glucose,blood lipid,islet β-cell function,IR and renal function.3.SBP,HbA1c,C-peptide and AIb are independent contributing elements for irisin,while HbA1c,AIb and ACR are independent contributing elements for chemerin.These are suggested that irisin and chemerin may jointly mediate the occurrence of T2 DKD through the fluctuation of blood glucose and renal filtration function. |
