成纤维细胞生长因子21与2型糖尿病患者肾脏微血管病变机制的相关性研究OA

Objective To investigate the association between fibroblast growth factor 21(FGF21)levels and the risk of renal microvascular disease in patients with type 2 diabetes mellitus(T2DM),and to explore the effects of glucagon-like peptide-1 receptor agonist(GLP-1RA)on these parameters.Methods A total of 64 T2DM patients who visited the outpatient clinic or were hospitalized in this department from November 2021 to December 2022 were randomly selected as the experimental group,and 32 healthy individuals who un-derwent physical examination at this hospital during the same period were selected as the control group.The urinary albumin-to-creatinine ratio(UACR)was used to assess renal microvascular disease and renal function.General data,biomarkers,and laboratory test results were collected from both groups.Statistical analyses were performed using descriptive statistics,t-test,chi-square test,univariate and multivariable linear regression,and logistic regression models.Subgroup analysis was also conducted based on whether patients in the experimen-tal group received GLP-1RA.Results The FGF21 and UACR levels in the experimental group[(203.20±44.89)pg/mL,2.4(1.3,6.5)mg/mmol]were significantly higher than those in the control group[(112.40±19.23)pg/mL,0.6(0.5,1.2)mg/mmol],with statistically significant differences(P<0.05).The body mass index(BMI),alanine aminotransferase,triglyceride(TG),and low-density lipoprotein cholesterol(LDL-C)lev-els in the experimental group were significantly higher than those in the control group,with statistically sig-nificant differences(P<0.05).Multivariate regression showed FGF21 positively correlated with BMI(B=3.91,P<0.001)and log10-UACR(B=13.46,P=0.004),and negatively with aspartate aminotransferase(B=1.78,P<0.001).Univariate regression showed positive correlations with TG,LDL-C,and log10-UACR(P=0.005,0.010,and<0.001,respectively).Multivariable logistic regression analysis showed that renal mi-crovascular disease in T2DM patients was significantly associated with FGF21 and was also a risk factor(odds ratio=1.03,95%confidence interval 1.01-1.05,P=0.004).Linear regression and logistic regression analy-ses revealed that GLP-1RA use was negatively but non-significantly associated with the risk of renal microvas-cular disease and FGF21 levels(P>0.05).Conclusion FGF21 level is a risk factor for renal microvascular disease in T2DM patients.GLP-1RA may exert vascular protective effects by modulating FGF21 levels.