2型糖尿病合并不同程度蛋白尿患者的血清对足细胞自噬的影响  

Effect of serum on podocyte autophagy in patients with type 2 diabetes mellitus complicated by different degrees of albuminuria

作　　者：雍慧娟 朱仙艺 叶小龙[1] 冯亚敏[1] 鲁一兵[1] 丁大法[1] YONG Hui-juan;ZHU Xian-yi;YE Xiao-long;FENG Ya-min;LU Yi-bing;Ding Da-fa(Department of Endocrinology,The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011 , Jiangsu , China)

机构地区：[1]南京医科大学第二附属医院内分泌科,江苏南京210011

出　　处：《川北医学院学报》2017年第4期507-510,共4页Journal of North Sichuan Medical College

基　　金：国家自然科学青年基金(H0713);江苏省大学生创新创业训练计划(201610312013Z)

摘　　要：目的:探讨2型糖尿病(T2DM)合并不同程度蛋白尿患者的血清对足细胞自噬的影响。方法:选取40例T2DM患者,根据尿白蛋白与尿肌酐比值(UACR)分为正常白蛋白尿组(15例)、微量白蛋白尿组(14例)和大量白蛋白尿组(11例),同时选取14例正常体检者为对照组,比较4组空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、收缩压、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、ACR等临床指标。分别用各组受试者的血清处理小鼠足细胞48 h后,观察电镜下足细胞自噬形态、自噬蛋白LC3及凋亡蛋白Cleaved-caspase 3水平的变化。结果:与对照组比较,T2DM各组ACR、FBG、Hb A1c、LDL-C、收缩压明显升高,HDL-C明显降低(P<0.01);T2DM各组ACR比较差异有统计学意义(P<0.01)。与对照组比较,T2DM各组自噬数目下降,LC3-Ⅱ表达量降低,Cleaved-caspase 3表达量增加;与正常白蛋白尿组比较,微量白蛋白尿组和大量白蛋白尿组LC3-Ⅱ表达量下降(P<0.05),Cleaved-caspase 3表达量增加(P<0.01);LC3-Ⅱ表达量水平与T2DM患者蛋白尿增加呈负相关(P<0.05)。结论:T2DM合并不同程度蛋白尿患者的血清能降低足细胞自噬,提示患者血清中含有相关因子调控自噬,进而损伤足细胞,促进蛋白尿产生。Objective:To explore the effect of serum on the podocyte autophagy in patients with type2diabetes mellitus(T2DM)complicated by different degrees of albuminuria.Methods:According to urinary albumin-to-creatinine ratio(UACR),40pa-tients with T2DM were divided into normal albuminuria group(n,=15),microalbuminuria group(n,=14)and macroalbuminuria group(n,=11).Meanwhile,14healthy people were selected as control group.The clinical indexes of fasting blood glucose(FBG),glycosylat-ed hemoglobin(HbAlc),systolic blood pressure,low density lipoprotein cholesterin(LDL-C),high density lipoprotein cholesterin(HDL-C)and ACR were all compared in four groups.After the mouse podocytes were intervened48h by the subject serum in each group,the changes of podocyte autophagymorphology,autophagy protein LC3and apoptosis protein Cleaved-caspase3levels were ob-served.Results:Compared with control group,ACR,FBG,HbAlc,LDL-C and systolic blood pressure were all increased,while HDL-C was decreased significantly in each group of T2DM(P<0.01).Significant differences were shown among each group of T2DM regard-ing the ACR(P<0.01).Compared with control group,both the number of podocyteautophagy and level of LC3-H expression went down,whereas the level of Cleaved-caspase3expression went up in each group of T2DM.Compared with normal albuminuria group,the level of LC3-II expression increased(P<0.05),while that of Cleaved-caspase3expression decreased in both microalbuminuria and macroalbuminuria groups(P<0.01).The level of LC3-II expression was negatively correlated with increased albuminuria in patients with T2DM(P<0.05).Conclusion:The serum in T2DM patients with different degrees of albuminuria can reduce the podocyte auto-phagy,suggesting that the serum in T2DM patients with different degrees of albuminuria contains relevant factors to regulate the autoph-agy,which can damage the podocytes and increase albuminuria.

关 键 词：2型糖尿病 足细胞 白蛋白尿 自噬 血清 

分 类 号：R692[医药卫生—泌尿科学]