糖尿病肾病患者血清TRPM7、Sirtuin-1与钙磷代谢、颈动脉钙化的相关性

Associations of serum TRPM7 and Sirtuin-1 with calcium and phosphorus metabolism and carotid artery calcification in patients with diabetic nephropathy

摘要:

目的 探讨糖尿病肾病（DN）患者血清瞬时受体电位通道7（TRPM7）、沉默调节蛋白-1（Sirtuin-1）与钙磷代谢、颈动脉钙化的相关性。方法 选取2020年12月—2022年11月成都大学附属医院收治的97例DN患者作为DN组，另取同期在该院就诊的120例2型糖尿病患者作为对照组。采用实时荧光定量聚合酶链反应检测血清TRPM7的表达，酶联免疫吸附试验检测血清Sirtuin-1水平。采用Pearson法分析DN患者血清TRPM7、Sirtuin-1水平与钙磷代谢的相关性，并通过多因素Logistic逐步回归模型分析DN患者颈动脉钙化的危险因素。结果 DN组血肌酐、尿素氮、血清TRPM7、血磷、颈动脉钙化率高于对照组（P <0.05）。DN组Sirtuin-1、血钙低于对照组（P <0.05）。Pearson相关性分析结果显示，DN患者血清TRPM7与血钙呈负相关（r =-0.247，P =0.000），与血磷呈正相关（r =0.415，P =0.000）；DN患者血清Sirtuin-1与血钙呈正相关（r =0.367，P =0.000），与血磷呈负相关（r =-0.505，P =0.000）。钙化组DN患者糖尿病病程、空腹血糖、血肌酐、血磷、TRPM7水平高于非钙化组（P <0.05），血镁、血钙、Sirtuin-1水平低于非钙化组（P <0.05）。多因素Logistic逐步回归分析结果显示：血镁≤ 0.89mmol/L ［O^R=2.277（95% CI：1.521，3.410）］、TRPM7≥1.41 ［O^R=3.019（95% CI：1.901，4.795）］、Sirtuin-1 ≤ 8.81 ng/mL ［O^R=2.591（95% CI：1.657，4.051）］是DN患者颈动脉钙化的危险因素（P <0.05）。结论 DN患者血清TRPM7升高、血清Sirtuin-1降低，两者与钙磷代谢密切相关，且血清TRPM7高表达、Sirtuin-1低表达是DN患者颈动脉钙化的危险因素。

Abstract:

Objective To explore the associations of serum transient receptor potential cation channel subfamily M member 7 (TRPM7) and silent mating-type information regulation 2 homolog 1 (Sirtuin-1) with calcium and phosphorus metabolism and carotid artery calcification in patients with diabetic nephropathy (DN).Methods Ninety-seven patients with DN admitted to our hospital from December 2020 to November 2022 were selected as the DN group, and 120 patients with type 2 diabetes admitted to our hospital during the same period were selected as the control group. The serum level of TRPM7 was detected by quantitative real-time polymerase chain reaction, and the serum level of Sirtuin-1 was detected by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to explore the association of serum levels of TRPM7 and Sirtuin-1 with calcium and phosphorus metabolism in patients with DN, and the risk factors for carotid artery calcification in patients with DN were determined via multivariable Logistic regression analysis.Results The levels of serum creatinine, blood urea nitrogen, serum TRPM7 and blood phosphorus in the DN group were higher than those in the control group (P < 0.05). In contrast, the levels of serum Sirtuin-1 and blood calcium in the DN group were lower than those in the control group (P < 0.05). Pearson correlation analysis showed that the serum level of TRPM7 was negatively correlated with the level of blood calcium (r = -0.247, P = 0.000) and was positively correlated with the level of blood phosphorus (r = 0.415, P = 0.000), and that the serum level of Sirtuin-1 was positively correlated with the level of blood calcium (r = 0.367, P = 0.000) and negatively correlated with the level of blood phosphorus (r = -0.505, P = 0.000) in DN patients. Compared with DN patients without carotid artery calcification, those with carotid artery calcification had longer disease course of diabetes mellitus, higher levels of fasting blood glucose, serum creatinine, blood phosphorus and serum TRPM7, and lower levels of blood magnesium, blood calcium and serum Sirtuin-1 (P < 0.05). The multivariable Logistic regression analysis revealed that the level of blood magnesium ≤ 0.89 mmol/L [O^R = 2.277 (95% CI: 1.521, 3.410) ], the serum level of TRPM7 ≥ 1.41 [O^R = 3.019 (95% CI: 1.901, 4.795) ], and the serum level of Sirtuin-1 ≤ 8.81 ng/mL [O^R = 2.591 (95% CI: 1.657, 4.051) ] were risk factors for carotid artery calcification in patients with DN (P < 0.05).Conclusions The serum level of TRPM7 is increased while that of Sirtuin-1 is decreased in DN patients, both of which are closely related to calcium and phosphorus metabolism. Besides, high expression of TRPM7 and low expression of Sirtuin-1 in the serum are risk factors for carotid artery calcification in DN patients.