血管生成抑制蛋白1在不同尿白蛋白排泄率2型糖尿病患者血清中的表达水平及临床意义  

Expression levels of serum vasohibin-1 in type 2 diabetes mellitus patients with different excretion rates ofurinary albumin and its clinical significance

作　　者：任慧雯[1] 吕川[1] 邵滢[1] 吴灿[1] 王晓宇[1] 安丽[1] 王秋月[1] 

机构地区：[1]中国医科大学附属第一医院内分泌与代谢病科,沈阳110001

出　　处：《中华内分泌代谢杂志》2016年第8期647-651,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：辽宁省高等学校“高端人才队伍建设工程”项目（[2014]187）

摘　　要：目的研究不同尿白蛋白排泄率（urinary albumin to creatinineratio，UACR）的2型糖尿病T2DM）患者血清血管生成抑制蛋白1（vasohibin-1，VASH-1）的表达水平，探讨其与T2DM微血管并发症糖录病。肾病（Diabetic nephropathy，DN）炎症反应及纤维化的相关关系。方法选择T2DM患者486例，分为E常白蛋白尿组（134例，UACR〈30mg／g）、微量白蛋白尿组（122例，UACR30-300mg／g）、大量白蛋白尿且（106例，UACR〉300mg／g）和大量白蛋白尿高血压组（124例，UACR〉300mg／g，且患有高血压），并设正静对照组（130例），询问年龄、病程，分别测定各项生化指标以及血清VASH-1、炎症指标（CRP、ESR）和纤维化指标（TGF-β1）的水平。结果正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组及大量白蛋白尿高．Ⅱ压组的UACR、HbA1c、ESR、CRP、TGF-β1和VASH-1的水平显著高于正常对照组（P〈0．05）；T2DM患者．Ⅱ清VASH．1水平与UACR、HbA1cESR、CRP和TGF-β1水平呈显著正相关（r=0．521、0．261、0．519、．523、0．479，P〈0．001），血清UACR、HbA1c、ESR、CRP和TGF-β1的水平是影响血清VASH-1水平的重要g素。结论血清VASH．1的水平可能成为早期预测T2DM患者DN的新标志物，VASH-1为糖尿病肾脏觅伤的炎症反应及纤维化过程提供了新的思路和方向。Objective To investigate the expression levels of serum vasohibin-1 （ VASH-1 ） in type 2 diabetes mellitns （ T2DM ） patients at different stages of urinary albumin to creatinineratio （UACR） and to attempt to investigate the relationship between VASH-1 and inflammation and fibrosis in the pathogenesis of diabetic nephropathy（ DN）, one of the microvascular complications of T2DM. Methods 486 patients with T2DMwere divided into four groups： normal albuminuria [ UACR〈30 mg/g, n = 134 ], microalbuminuria [ UACR at 30-300 mg/g, n = 122 ], clinical albuminuria [ UACR 〉 300 mg/g, n = 106 ], and clinical albuminuria hypertensive [ UACR 〉 300 mg/g, with hypertension, n = 124 ] groups. Age, course, serum levels of VASH1, inflammation markers （ CRP, ESR） and fibrosis marker（ TGF-β1 ） with other biochemical indicators were measured, and 130 normal control subjects were also included. Results Compared with normal control group, the levels of UACR, HbA1c, ESR, CRP, TGF-β1 and VASH-1 in groups ofnormal albuminuria, mieroalbuminuria, clinical albuminuria, and clinical albuminuria hypertensive were significantly higher （ P 〈 0.05 ）. Pearson correlation analysis showed that levels of VASH-1 were positively correlated with UACR, HbAlc ,ESR, CRPand TGF-β1 （ r = 0. 521, 0. 261, 0. 519, 0. 523, 0. 479, P〈 0. 001 ）, while multivariate regression analysis showed that levels of UACR, HbAlc, ESR, CRP and TGF-131 were important factors affecting serum VASH-1 levels. Conclusion Serum levels of VASH-1 may become new biomarkers of early diagnosis of DN. Consequently, VASH-1 level may provide a new pattern and direction of inflammation and fibrosis for consideration in diabetic kidney damage.

关 键 词：糖尿病肾病 转化生长因子Β1 血管生成抑制蛋白1 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]