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Abstract：
To explore the correlations between diabetic nephropathy (DN) and serum levels of glutathione peroxidase 4 (GPX4), acyl-CoA synthetase long-chain family member 4 (ACSL4), iron, transferrin (Tf), and ferritin in patients with type 2 diabetes mellitus (T2DM).
According to the urinary albumin excretion rate(UAER) or estimated glomerular filtration rate (eGFR) levels, a total of 123 patients with T2DM were separately divided into normoalbuminuria (NO), microalbuminuria (MI), macroalbuminuria (MA) groups, and G1 (eGFR ≥ 90 mL/min), G2 (eGFR ≤ 60 mL/min to < 90 mL/min), and G3 groups (eGFR< 60 mL/min), with 33 healthy participants as the control (HC). The differences in serum GPX4, ACSL4, iron, Tf, and ferritin levels between groups were compared, and the relationships between these levels were analysed. The independent correlations between UAER or DN severity and serum GPX4, ACSL4, iron, Tf, and ferritin levels were analysed by multiple linear and multinomial logistic regression, respectively.
To the patients with T2DM, with the increase in UAER levels, GPX4, iron, and Tf levels gradually decreased, whereas ACSL4 levels increased, meanwhile with the decrease in eGFR levels, GPX4 and Tf levels gradually decreased, whereas ACSL4 levels increased. UAER were independently and positively correlated with ACSL4 [β = 17.53, 95% confidence interval (CI; 11.94, 23.13)] and negatively correlated with GPX4 [β = -1.633, 95% CI (-2.77, -0.496)] and Tf [β = -52.94, 95% CI (-95.78, -10.11)].The NO and MI groups were considered as reference groups, respectively. The severity of DN was negatively correlated with serum GPX4 [odds ratio (OR) = 0.925 and 0.902, p =0.015 and 0.001], and Tf (OR = 0.109 and 0.119, p =0.043 and 0.034), and positively correlated with ACSL4 (OR = 1.952 and 1.865, both p <0.001) in the MA group.
DN severity was negatively correlated with serum GPX4 and Tf levels and positively correlated with serum ACSL4 levels in patients with T2DM.
According to the urinary albumin excretion rate(UAER) or estimated glomerular filtration rate (eGFR) levels, a total of 123 patients with T2DM were separately divided into normoalbuminuria (NO), microalbuminuria (MI), macroalbuminuria (MA) groups, and G1 (eGFR ≥ 90 mL/min), G2 (eGFR ≤ 60 mL/min to < 90 mL/min), and G3 groups (eGFR< 60 mL/min), with 33 healthy participants as the control (HC). The differences in serum GPX4, ACSL4, iron, Tf, and ferritin levels between groups were compared, and the relationships between these levels were analysed. The independent correlations between UAER or DN severity and serum GPX4, ACSL4, iron, Tf, and ferritin levels were analysed by multiple linear and multinomial logistic regression, respectively.
To the patients with T2DM, with the increase in UAER levels, GPX4, iron, and Tf levels gradually decreased, whereas ACSL4 levels increased, meanwhile with the decrease in eGFR levels, GPX4 and Tf levels gradually decreased, whereas ACSL4 levels increased. UAER were independently and positively correlated with ACSL4 [β = 17.53, 95% confidence interval (CI; 11.94, 23.13)] and negatively correlated with GPX4 [β = -1.633, 95% CI (-2.77, -0.496)] and Tf [β = -52.94, 95% CI (-95.78, -10.11)].The NO and MI groups were considered as reference groups, respectively. The severity of DN was negatively correlated with serum GPX4 [odds ratio (OR) = 0.925 and 0.902, p =0.015 and 0.001], and Tf (OR = 0.109 and 0.119, p =0.043 and 0.034), and positively correlated with ACSL4 (OR = 1.952 and 1.865, both p <0.001) in the MA group.
DN severity was negatively correlated with serum GPX4 and Tf levels and positively correlated with serum ACSL4 levels in patients with T2DM.
摘要：
■探讨糖尿病肾病（DN）与血清谷胱甘肽过氧化物酶4（GPX4）水平的相关性。酰基辅酶A合成酶长链家族成员4（ACSL4），铁,转铁蛋白（Tf），和铁蛋白在2型糖尿病（T2DM）患者中的应用。
■根据尿白蛋白排泄率（UAER）或估计的肾小球滤过率（eGFR）水平，总共123例T2DM患者分别分为正常白蛋白尿(NO),微量白蛋白尿（MI），大量白蛋白尿（MA）组，和G1（eGFR≥90mL/min），G2（eGFR≤60mL/min至<90mL/min），和G3组（eGFR<60mL/min），以33名健康参与者为对照（HC）。血清GPX4、ACSL4、铁、Tf,比较各组间的铁蛋白水平，并分析了这些水平之间的关系。UAER或DN严重程度与血清GPX4、ACSL4、铁、Tf,用多元线性和多项逻辑回归分析铁蛋白水平，分别。
■对T2DM患者，随着UAER水平的提高，GPX4，铁，Tf水平逐渐下降，而ACSL4水平增加，同时随着eGFR水平的下降，GPX4和Tf水平逐渐下降，而ACSL4水平增加。UAER与ACSL4呈独立正相关[β=17.53,95%置信区间(CI;11.94,23.13)],与GPX4呈负相关[β=-1.633,95%CI(-2.77,-0.496)]和Tf[β=-52.94,95%CI(-95.78,-10.11)]。NO和MI组被视为参照组，分别。DN的严重程度与血清GPX4呈负相关[比值比(OR)=0.925和0.902,p=0.015和0.001],和Tf(OR=0.109和0.119，p=0.043和0.034)，在MA组中，与ACSL4呈正相关（OR=1.952和1.865，均p<0.001）。
■T2DM患者DN严重程度与血清GPX4、Tf水平呈负相关，与血清ACSL4水平呈正相关。
■根据尿白蛋白排泄率（UAER）或估计的肾小球滤过率（eGFR）水平，总共123例T2DM患者分别分为正常白蛋白尿(NO),微量白蛋白尿（MI），大量白蛋白尿（MA）组，和G1（eGFR≥90mL/min），G2（eGFR≤60mL/min至<90mL/min），和G3组（eGFR<60mL/min），以33名健康参与者为对照（HC）。血清GPX4、ACSL4、铁、Tf,比较各组间的铁蛋白水平，并分析了这些水平之间的关系。UAER或DN严重程度与血清GPX4、ACSL4、铁、Tf,用多元线性和多项逻辑回归分析铁蛋白水平，分别。
■对T2DM患者，随着UAER水平的提高，GPX4，铁，Tf水平逐渐下降，而ACSL4水平增加，同时随着eGFR水平的下降，GPX4和Tf水平逐渐下降，而ACSL4水平增加。UAER与ACSL4呈独立正相关[β=17.53,95%置信区间(CI;11.94,23.13)],与GPX4呈负相关[β=-1.633,95%CI(-2.77,-0.496)]和Tf[β=-52.94,95%CI(-95.78,-10.11)]。NO和MI组被视为参照组，分别。DN的严重程度与血清GPX4呈负相关[比值比(OR)=0.925和0.902,p=0.015和0.001],和Tf(OR=0.109和0.119，p=0.043和0.034)，在MA组中，与ACSL4呈正相关（OR=1.952和1.865，均p<0.001）。
■T2DM患者DN严重程度与血清GPX4、Tf水平呈负相关，与血清ACSL4水平呈正相关。
