老年2型糖尿病患者TGF-β1-Smad/p38 MAPK信号通路与肾功能的关系  

Relationship between TGF-β1-Smad/p38 MAPK signaling pathway and renal function in elderly patients with diabetes mellitus type 2

作　　者：李生香 邓宝娟[1] 高秀 LI Sheng-xiang;DENG Bao-juan;GAO Xiu(Department of General Practice,Yulin First Hospital,Yulin Shaanxi 719000,China)

机构地区：[1]榆林市第一医院全科医学科,陕西榆林719000

出　　处：《临床和实验医学杂志》2025年第6期601-605,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省科技厅科研基金资助项目(编号:2020489)。

摘　　要：目的探讨老年2型糖尿病(T2DM)患者转化生长因子β1(TGF-β1)-Smad/p38丝裂原激活蛋白激酶(MAPK)信号通路与肾功能的关系。方法回顾性分析2023年8月至2024年8月榆林市第一医院收治的96例糖尿病肾病(DN)患者的临床资料,纳入DN组,另将同期于本院就诊的96例单纯糖尿病患者纳入对照组。检测并比较两组TGF-β1、Smad1、Smad2、Smad3、p38MAPK、磷酸化p38MAPK(p-p38MAPK)、p-p38MAPK/p-38MAPK水平及肾功能指标[尿α1-微球蛋白(α1-MG)、尿素氮、血清肌酐];采用Pearson相关性分析对老年T2DM患者TGF-β1-Smad/p38 MAPK信号通路与肾功能的相关性进行分析;通过受试者操作特征(ROC)曲线分析TGF-β1-Smad/p38 MAPK信号通路表达水平诊断DN的价值。结果DN组TGF-β1、Smad1、Smad2、Smad3、p38MAPK、p-p38MAPK、p-p38MAPK/p-38MAPK水平分别为0.59±0.12、0.56±0.11、0.42±0.10、0.55±0.10、0.51±0.13、0.26±0.08、0.51±0.09,均显著高于对照组(0.40±0.13、0.46±0.12、0.35±0.09、0.40±0.09、0.39±0.11、0.14±0.04、0.36±0.08),差异均有统计学意义(P<0.05)。DN组尿α1-MG、尿素氮、血清肌酐水平分别为(46.17±9.05)mg/L、(10.33±3.18)mmol/L、(142.76±21.83)μmol/L,均显著高于对照组[(17.43±4.96)mg/L、(5.61±1.37)mmol/L、(100.36±13.44)μmol/L],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,老年T2DM患者TGF-β1、Smad1、Smad2、Smad3、p38MAPK、p-p38MAPK表达水平与尿α1-MG、尿素氮、血清肌酐水平均呈正相关(P<0.05)。ROC曲线分析结果显示,TGF-β1、Smad1、Smad2、Smad3、p38MAPK诊断DN的曲线下面积分别为0.860、0.790、0.803、0.848、0.794,敏感度分别为0.781、0.771、0.760、0.781、0.813,且P<0.05。结论老年T2DM患者TGF-β1-Smad/p38 MAPK信号通路表达水平显著升高,且与肾功能呈正相关。Objective To investigate the relationship between transforming growth factor β1(TGF-β1)-Smad/p38 mitogen activation protein kinase(MAPK)signaling pathway and renal function in elderly patients with diabetes mellitus type 2(T2DM).Methods The clinical data of 96 patients with diabetic nephropathy(DN)admitted to Yulin First Hospital from August 2023 to August 2024 were retrospectively analyzed and included in the DN group,and 96 patients with simple diabetes admitted to our hospital during the same period were included in the control group.The levels of TGF-β1,Smad1,Smad2,Smad3,p38MAPK,phosphorylation p38MAPK(p-p38MAPK),p-p38MAPK/p-38MAPK and renal function indexes[α1-microglobulin(α1-MG)in urine,urea nitrogen,serum creatinine]in the two groups were detected and compared.The correlation between TGF-β1-Smad/p38 MAPK signaling pathway and renal function in elderly patients with T2DM was analyzed by Pearson correlation analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of TGF-β1-Smad/p38 MAPK signaling pathway expression level in DN.Results The levels of TGF-β1,Smad1,Smad2,Smad3,p38MAPK,p-p38MAPK,p-p38MAPK/p-38MAPK in DN group were 0.59±0.12,0.56±0.11,0.42±0.10,0.55±0.10,0.51±0.13,0.26±0.08,0.51±0.09,respectively,which were significantly higher than those in the control group(0.40±0.13,0.46±0.12,0.35±0.09,0.40±0.09,0.39±0.11,0.14±0.04,0.36±0.08),the differences were statistically significant(P<0.05).Urinary α1-MG,urea nitrogen,serum creatinine levels in DN group were(46.17±9.05)mg/L,(10.33±3.18)mmol/L,(142.76±21.83)μmol/L,respectively,which were significantly higher than those in the control group[(17.43±4.96)mg/L,(5.61±1.37)mmol/L,(100.36±13.44)μmol/L],the differences were statistically significant(P<0.05).Pearson correlation analysis results showed that the expression levels of TGF-β1,Smad1,Smad2,Smad3,p38MAPK and p-p38MAPK in elderly T2DM patients were positively correlated with urinary α1-MG,urea nitrogen and serum creatinine levels(P<0.05)

关 键 词：糖尿病 2型 肾功能 转化生长因子Β1 SMAD P38丝裂原活化蛋白激酶 

分 类 号：R587.2[医药卫生—内分泌]