血清全段成纤维细胞生长因子-23在2型糖尿病肾病不同分期中的变化

目的研究2型糖尿病肾病(DN)不同临床分期患者血清全段成纤维细胞生长因子-23(iFGF-23)水平的变化,探讨2型糖尿病患者血清iFGF-23水平、尿微量白蛋白排泄率(UAER)和肾功能变化的相关性。方法选取2型糖尿病患者共119例,根据尿微量白蛋白排泄率分为4组:尿微量白蛋白排泄率正常组(DM1组,8°UAER20μg/min,血清肌酐水平正常)30例;微量白蛋白尿组(DM2组,8°UAER20~200μg/min,血清肌酐水平正常)30例;临床蛋白尿组(DM3组,8°UAER200μg/min,血清肌酐水平正常)28例;尿毒症血液透析组(DM4组)31例。正常对照组(N组)29例。收集受试者基本资料,空腹静脉采血测血糖、血脂,肝、肾功能,全段甲状旁腺激素(iPTH),血清iFGF-23,DM1组、DM2组、DM3组留取8h尿检测8°UAER。所有资料应用SPSS22.0软件包进行统计学分析。结果DM4组血清iFGF-23为558.93(168.65~2333.5)pg/mL水平显著高于其他组(P0.001),但其他各组间差异无统计学意义。血清iFGF-23水平和肾小球滤过率(eGFR)呈负相关,与血清肌酐(Scr),尿素氮(BUN),葡萄糖(GLU),血磷(P),碱性磷酸酶(ALP),iPTH呈正相关。结论糖尿病肾病晚期血清iFGF-23水平显著升高,血清iFGF-23水平与血磷、血清肌酐、尿素氮和iPTH呈正相关,与eGFR水平显著负相关。提示iFGF-23不能作为DN早期的生化标志物。     

同型半胱氨酸与糖尿病肾病

对80例T2DM患者及30例正常人测定HCY,。根据尿微量白蛋白排泌率UAER将糖尿病分为DN组UAER≤20μg/min、早期DN组20μg/min≤UAER≤200μg/min、临床尿蛋白组UAER≥200μg/min。结果:三组分别与对照组比较、A组与B组、B组与C组、A组与C组比较P≤0.05。结论:高Hcy血症与DN呈正相关性。     

核素肾动态显像对老年2型糖尿病患者肾功能的研究

目的了解老年2型糖尿病(DM)患者不同病程阶段肾脏血流动力学变化及肾功能受损情况.方法将50例2型糖尿病患者根据尿白蛋白排泄率(UAER)分为3组(1)DM正常白蛋白尿组(DM1组)10例,UAER＜20μg*min-1.(2)DM微量白蛋白尿组(DM2组)20例,UAER20～200μg*min-1.(3)DM临床蛋白尿组(DM3组)20例,UAER＞200μg*min-1.与20例正常对照组(NC组)一起进行99mTc-DTPA(99mTc-二乙三胺五乙酸)和99mTc-EC(99mTC-半胱氨酸)肾动态显像.结果DM1组肾小球滤过率(GFR)和肾有效血流量(ERPF)明显高于NC组(P＜0.01).DM2组GFR,ERPF与NC组相比无差异,但其99mTc-EC测定的肾功能曲线半排时间(T1/2)延长(P＜0.01),20min残留率(C20)增高(P＜0.05).DM3组GFR、ERPF明显下降(P＜0.01),肾功能曲线峰时间(Tp)后延(P＜0.05),T1/2更加延长(P＜0.01),C20更加增多(P＜0.01).结论核素肾动态显像可早期诊断老年2型糖尿病肾病,并了解肾功能受损程度,其程度随病程的延长而加重.     

2型糖尿病患者血清胆红素与尿白蛋白的相关性研究

目的 探讨2型糖尿病患者血清胆红素与尿白蛋白水平之间的相关性.方法 选取2型糖尿病患者686例,根据尿白蛋白排泄率(UAER)水平将其分为正常白蛋白尿组(UAER＜20 μg/min,329例)、微量白蛋白尿组(20 μg/min≤UAER＜ 200 μg/min,297例)和显性白蛋白尿组(UAER≥200 μg/min,60例),比较3组间血清胆红素水平的差异,采用Spearman相关分析和Stepwise多元逐步回归分析评价胆红素对UAER的影响.结果 显性白蛋白尿组患者的总胆红素(TBIL)、直接胆红素(DBIL)和间接胆红素(IBIL)水平[分别是(8.4±3.7)μmol/L、(2.3±1.2)μmol/L和(6.1±3.0) μmol/L]较微量白蛋白尿组[分别是(10.6±4.8) μmol/L、(3.1±1.7)μmol/L和(7.4±3.5) μmol/L]和正常白蛋白尿组[(11.3±6.3)μmol/L、(3.5±2.8) μmol/L和(7.8±4.3) μmol/L]显著降低(P＜0.01或P＜0.05).TBIL(r=-0.084,P=0.027)、DBIL(r=-0.110,P=0.005)与UAER呈显著负相关.结论胆红素可能是2型糖尿病肾病的保护性因素,应重视胆红素的抗氧化作用.     

血管紧张素Ⅱ受体拮抗剂对糖尿病肾病患者微量白蛋白尿的作用不受血压影响

目的研究血管紧张素Ⅱ受体拮抗剂(ARB)氯沙坦对2型糖尿病、糖尿病肾病患者微量白蛋白尿的治疗效果。方法血压正常的2型糖尿病患者43例,其尿白蛋白排泄率(UAER)在20~200μg/min之间,其血糖控制在可接受水平[空腹血糖(FBG)≤7mmol/L,餐后2h血糖(P2hBG)≤10mmol/L]。随机分为治疗组23例,对照组20例,对照组在控制血糖基础上加用安慰剂,治疗组加用ARB氯沙坦50mg/d。两组患者在治疗前和治疗12周后复查FBG、P2hBG、糖化血红蛋白(HbA1c)和UAER。结果治疗12周后,治疗组UAER为(76±11)μg/min,与治疗前(119±14)μg/min相比明显下降(P<0·05),与对照组(125±13)μg/min比较,差异有显著性(P<0·05)。结论对血压正常的2型糖尿病早期糖尿病肾病患者,ARB氯沙坦在对血压无影响的情况下具有独特的降低尿微量白蛋白水平,延缓糖尿病肾病进展的作用。     

血管紧张素Ⅱ受体拮抗剂对糖尿病肾病患者微量白蛋白尿的作用不受血压影响

目的 研究血管紧张素Ⅱ受体拮抗剂(ARB)氯沙坦对2型糖尿病、糖尿病肾病患者微量白蛋白尿的治疗效果.方法 血压正常的2型糖尿病患者43例,其尿白蛋白排泄率(UAER)在20～200 μg/min之间,其血糖控制在可接受水平[空腹血糖(FBG)≤7 mmol/L,餐后2 h血糖(P2hBG)≤10 mmol/L].随机分为治疗组23例,对照组20例,对照组在控制血糖基础上加用安慰剂,治疗组加用ARB氯沙坦50 mg/d.两组患者在治疗前和治疗12周后复查FBG、P2hBG、糖化血红蛋白(HbA1c)和UAER.结果 治疗12周后,治疗组UAER为(76±11)μg/min,与治疗前(119±14)μg/min相比明显下降(P＜0.05),与对照组(125±13)μg/min比较,差异有显著性(P＜0.05).结论 对血压正常的2型糖尿病早期糖尿病肾病患者,ARB氯沙坦在对血压无影响的情况下具有独特的降低尿微量白蛋白水平,延缓糖尿病肾病进展的作用.     

糖耐量减低者和2型糖尿病患者尿8-羟基脱氧鸟苷的变化及其临床意义

目的 探讨IGT及T2DM患者尿8-羟基脱氧鸟苷（8-OHdG）的水平. 方法 选取IGT者（IGT组）、T2DM患者（T2DM组）及正常对照（NC）者各40名.收集24 h尿,通过ELISA检测尿液中8-OHdG含量,苦味酸法测定尿肌酐（Ucr）浓度,采用酶法测定血糖、肾功能,高效液相色谱法测定HbA1 c,Clauss法测定纤维蛋白原（FIB）. 结果 8-OHdG在NC、IGT、T2DM组逐次递增[（6.97±2.13）vs（9.32±2.51）vs（12.26±3.57） ng/mgCr],比较差异有统计学意义（P＜0.05）.经相关性分析及多元逐步回归分析发现,2 hPG与尿8-OHdG呈正相关,对尿8-OHdG水平影响较大. 结论 （1）IGT和T2DM患者尿8-OHdG水平升高;（2）2 hPG是影响体内氧化应激的主要因素.     

2型糖尿病患者血清残粒样微粒胆固醇水平及其临床意义

目的　探讨血清残粒样微粒胆固醇(RLP C)在糖尿病(DM)患者中的变化及其与糖尿病肾病(DN)的关系。方法　血清RLP C浓度用免疫分离法测定,同时测定血浆α 颗粒膜蛋白 (GMP140)和血清一氧化氮(NO)。尿 24h微量白蛋白用放免法测定,根据尿白蛋白排泄率 (UAER)将其分为 3组。结果96例 2型DM患者RLP C与 44例正常对照 (NC)比较显著升高〔(0. 281±0. 162)mmol/Lvs(0. 193±0. 125)mmol/L,P<0. 01〕,且 2型DM患者D1 组 (UAER<20μg/min)、D2 组 (UAER20 ~200μg/min)和D3 组(UAER>200μg/min)相比,RLP C浓度依次显著增加〔( 0. 225±0. 145 )mmol/L, ( 0. 292±0. 181 )mmol/L, (0. 363±0. 192)mmol/L〕。D2 和D3 组GMP140浓度显著高于D1 和NC组(均P<0. 01),NC组和D1 组NO均显著高于D2 和D3 组 (均P<0. 01)。RLP C与NO呈高度负相关 (r=-0. 75,P<0. 01 ),与UAER和GMP140呈高度正相关(r=0. 78和r=0. 81,均P<0. 01),NO与GMP140浓度呈高度负相关 (r=-0. 78,P<0. 01)。结论　RLP C浓度在 2型DM患者中显著增加,且在并发DN的 2型DM患者增加更显著,RLP C在DN的发生发展中具有致病作用,其机制可能是通过损伤血管内皮和活化血小板所致。     

超敏CRP、D-二聚体及纤维蛋白原联合检测在Ⅱ型糖尿病肾病的临床诊疗价值

目的探讨联合检测超敏CRP(hs-CRP)、D-二聚体(D-Dimer)及纤维蛋白原(FIB)三个指标对Ⅱ型糖尿病肾病(Diabetic nephropathy,DN)的临床诊疗价值。方法将2013年3月—2014年3月在该院内分泌科确诊的136例Ⅱ型糖尿病患者,根据24 h尿液尿白蛋白排泄率(UAER),将其分为单纯糖尿病组(DM组,UAER20μg/min)45例、早期糖尿病肾病组(EDN组,UAER 20-200μg/min)47例和临床糖尿病肾病组(CDN组,UAER200μg/min)44例。另选44例健康体检者为对照组。所有受试者均空腹取静脉血,同时对hs-CRP、D-Dimer及FIB进行检测,进行组间比较,并将三者与UAER进行相关性分析。结果三组Ⅱ型DM患者hs-CRP、D-Dimer、FIB检测结果均高于对照组(P均0.05),且随UAER值的升高而增加,呈明显的正相关性。结论联合检测hs-CRP、D-Dimer及FIB对Ⅱ型DN早期诊疗的有重要临床应用价值。     

糖尿病肾病患者血清HCY、VEGF水平变化及意义

目的观察糖尿病肾病(DN)患者血清同型半胱氨酸(HCY)和血管内皮生长因子(VEGF)水平变化,并探讨其临床意义。方法根据24 h尿白蛋白排泄率(UAER)将67例糖尿病患者分为DM组19例、早期DN组20例、DN组28例,另选20例健康体检者作为对照组。采用荧光偏振免疫分析法测定血清HCY,双抗体夹心ELISA法测定血清VEGF。结果 DN组UAER及血清HCY、VEGF水平分别为(753.19±56.34)μg/min、(30.23±9.18)μmol/L、(255.26±24.17)pg/mL,早期DN组分别为(104.18±25.75)μg/min、(25.26±1058)μmol/L、(205.31±25.36)pg/mL,DM组分别为(10.25±0.14)μg/min、(14.98±11.23)μmol/L、(180.24±29.18)pg/mL,对照组分别为(9.1±0.35)μg/min、(8.15±2.34)μmol/L、(89.17±13.52)pg/mL;各组间两两比较,P均<0.05。早期DN组、DN组患者血清HCY与VEGF呈正相关(r分别为0.42、0.59,P均<0.01)、与UAER亦呈正相关(r分别为0.76、0.81,P均<0.01),血清VEGF与UAER呈正相关(r分别为0.55、0.68,P均<0.01)。结论 DN患者血清HCY、VEGF水平明显升高,二者在DN的发生和发展过程中可能起重要作用,可作为DN早期诊断的指标之一。     

The meaning of serum levels of advanced glycosylation end products in diabetic nephropathy

It has been reported that advanced glycosylation end products (AGEs) play an important role in the development of diabetic complications. To evaluate the relationship between serum AGEs and diabetic nephropathy, we measured serum AGE levels in diabetic patients with normoalbuminuria (N), microalbuminuria (M), overt proteinuria (O), and hemodialysis (HD), non diabetic patients with nephropathy, and age-matched control subjects using the enzyme-linked immunosorbent assay (ELISA). Urine AGE levels were also measured in these subjects except group HD. Serum AGE levels in diabetic patients were not significantly higher than those in the normal subjects. When we compared serum AGE levels among various stages of diabetic nephropathy, groups O and HD had significantly higher serum AGE levels than the other groups. Serum AGE levels in group HD were almost 6-fold higher than those in groups N and M. In contrast, there were no significant differences in urinary AGE levels among any diabetic groups. As for the variables that determine serum AGE levels in diabetic patients, there was no significant correlation between serum AGEs and fasting blood glucose, hemoglobin A1c (HbA1c), or duration of diabetes. In contrast, serum AGEs showed a strong correlation with serum creatinine and an inverse correlation with creatinine clearance. To evaluate the relationship between serum AGEs and oxidative stress in diabetic nephropathy, urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and serum malondialdehyde (MDA), which are biological markers of total oxidative stress in vivo, were also examined. Both urinary 8-OHdG and serum MDA levels were significantly higher in diabetic patients with proteinuria versus those without proteinuria. However, there was no significant correlation between serum AGEs and urinary 8-OHdG or serum MDA levels in diabetic patients. These results suggest that the accumulation of serum AGEs in diabetic nephropathy may be mainly due to decreased removal in the kidney rather than increased production by high glucose levels or oxidative stress.     

Effect of red wine on urinary protein, 8-hydroxydeoxyguanosine, and liver-type fatty acid-binding protein excretion in patients with diabetic nephropathy

The aim of the present study was to determine whether red or white wine affects urinary protein, 8-hydroxydeoxyguanosine (8-OHdG), and liver-type fatty acid-binding protein (L-FABP) excretion in type 2 diabetic nephropathy patients. Twenty-four type 2 diabetes mellitus patients with nephropathy were randomly allocated to drink a 118-mL (4-oz) glass of red wine (n = 12, group A) or white wine (n = 12, group B) daily for 6 months. Twelve type 2 diabetes mellitus patients with nephropathy who did not drink any wines served as control subjects (group C). Serum creatinine, 24-hour creatinine clearance, hemoglobin A_1c, urinary protein, urinary 8-OHdG, and urinary L-FABP were measured before and 3 and 6 months after the start of the study. In groups A, B, and C, serum creatinine, 24-hour creatinine clearance, and hemoglobin A_1c changed little during the experimental period. However, urinary protein, 8-OHdG, and L-FABP excretions were significantly decreased at 3 (P < .05) and 6 months (P < .01) compared with the baseline values in group A. In contrast, these markers changed little during the experimental period in groups B and C. Thus, these urinary markers were significantly lower in group A than in groups B and C at 3 and 6 months. These results suggest that red wine is renoprotective whereas white wine has no such effect in type 2 diabetes mellitus patients with nephropathy. The renoprotective effect of red wine may be due in part to its ability to reduce oxidative stress.     

氟伐他汀对2型糖尿病早期肾病尿蛋白的影响

目的观察氟伐他汀对2型糖尿病肾病早期尿蛋白、C反应蛋白的影响及探讨对糖尿病肾病的保护作用。方法2型早期糖尿病肾病60例,随机分为常规治疗组和常规治疗加睡前服用氟伐他汀组,测定治疗前后血糖、血脂、血肌酐、C反应蛋白、24小时尿蛋白、尿白蛋白排泄率等。结果氟伐他汀治疗后对无论有无血脂异常患者其尿白蛋白排泄率、24小时尿蛋白、C反应蛋白等均明显降低。结论氟伐他汀可通过非降脂效应减少尿蛋白,保护肾功能。     

Additive renoprotective effects of aliskiren on angiotensin receptor blocker and calcium channel blocker treatments for type 2 diabetic patients with albuminuria

This open-label, randomized, parallel-controlled study investigated the effects of the direct renin inhibitor aliskiren on 64 hypertensive type 2 diabetic patients with chronic kidney disease (CKD) and stable glycemic control who were already being treated with fixed doses of antihypertensive agents over a 24-week period. These agents were 80?mg of the angiotensin II receptor blocker (ARB) telmisartan and 5?mg of the calcium channel blocker (CCB) amlodipine. Patients were randomly assigned to two groups: the aliskiren group, receiving 150?mg per day aliskiren, which was increased to 300?mg per day (n=32), and the CCB group, which received an increased dose (7.5?mg per day) of amlodipine that was increased to 10?mg per day (n=32). Urinary albumin excretion and urinary levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and liver-type fatty acid-binding protein (L-FABP) were investigated in each group. Mean systolic and diastolic blood pressure decreased significantly in both groups, but there was no significant difference between the two groups at the end of the study. Serum creatinine levels and estimated glomerular filtration rate did not differ significantly between the two groups, but percent changes of urinary albumin/creatinine ratios, 8-OHdG and L-FABP levels decreased significantly in the aliskiren group compared with the CCB group. Plasma aldosterone levels were significantly decreased in the aliskiren group, which correlated significantly with those of urinary 8-OHdG and L-FABP. Our results suggest that the addition of aliskiren to the maximal recommended dose of ARB and usual dose of amlodipine is more effective in reducing albuminuria and oxidant stress in hypertensive diabetic patients with CKD than increasing the dose of amlodipine.     

糖尿病肾病并发下肢动脉病变的相关因素分析

目的探讨糖尿病肾病（DN）和糖尿病并发下肢动脉病变（PAD）的相关影响因素。方法选取,DN患者235例（DN组）,单纯糖尿病患者102例（DM组）,测定两组踝肱指数（ABI）及其他相关指标,研究下肢动脉病变发生情况及其影响因素。结果DN组下肢动脉病变发生率（63．0％）高于DM组（11．8％）,差别有统计学意义;DNPAD＋组、DNPAD-组、DMPAD＋组、DMPAD-组的年龄、SBP、DBP、LDL-C、FPG、肾小球滤过率（GFR）、纤维蛋白原（FBG）、UAlb／Cr、24h尿蛋白定量差别均具有统计学意义;DN组发生下肢动脉病变的可能影响因素是SBP、UAlb／Cr、GFR、24h尿蛋白定量;DM组发生下肢动脉病变的可能影响因素是SBP、DBP、24h尿蛋白定量。结论收缩压、纤维蛋白原和尿蛋白可能是DN患者并发下肢动脉病变的预警因子,应对其进行筛查,并给予积极的治疗,从而减少或延缓下肢血管病变的发生及发展。     

Probucol and atorvastatin decrease urinary 8-hydroxy-2'-deoxyguanosine in patients with diabetes and hypercholesterolemia

To clarify whether probucol and statins suppress oxidative stress in diabetic patients, we studied the effects of probucol and the statin atorvastatin on urinary 8-hydroxy-2'deoxyguanosine (8-OHdG) levels in diabetics with hypercholesterolemia. A randomized, open study was performed on a total of 36 patients with type 2 diabetes and hypercholesterolemia. The patients were randomly assigned to a probucol group (500 mg/day, n = 18) or an atorvastatin group (10 mg/day, n = 18). During three months, total- and LDL-cholesterol decreased significantly in both groups. LDL-cholesterol was significantly lower in the atorvastatin group than probucol group. HDL-C decreased significantly in the probucol group and did not change in the atorvastatin group. 8-OHdG decreased significantly in both groups after 3 months; 12.4 +/- 7.5 to 8.1 +/- 4.2 ng/mg/Cr in the atorvastatin group (p < 0.05) and 12.3 +/- 8.8 to 6.8 +/- 2.6 ng/mg/Cr in the probucol group (p < 0.05), and these changes did not differ significantly between the two groups. But, in patients with high 8-OHdG levels (more than 10 ng/mg/Cr) before administration, urinary 8-OHdG decreased significantly from 19.5 +/- 4.9 to 9.2 +/- 3.4 ng/mg Cr (p < 0.01) in the atorvastatin group, and from 19.7 +/- 8.2 to 6.67 +/- 2.2 ng/mg Cr (p < 0.01) in the probucol group. Urinary 8-OHdG was significantly lower in the probucol group than in the atorvastatin group after the second and third months of administration (p < 0.05). These results suggest that while probucol and atorvastatin both reduce systemic oxidative stress, probucol might be the more useful in patients with strong oxidative stress.     

Combination therapy with renin-angiotensin system inhibitors and the calcium channel blocker azelnidipine decreases plasma inflammatory markers and urinary oxidative stress markers in patients with diabetic nephropathy

A calcium channel blocker (CCB), azelnidipine (AZ), is reported to inhibit oxidative stresses, particularly when administered under blockade of the renin-angiotensin system (RAS). The purpose of this study was to investigate whether AZ inhibits oxidative stresses more potently than other CCBs under blockade of RAS and exerts renoprotection in type 2 diabetic nephropathy. Subjects were hypertensive type 2 diabetics with nephropathy, taking RAS inhibitors. The patients were randomly assigned to two groups, an AZ group (n=21, 16 mg/d) and a nifedipine-CR (NF) group (n=17, 40 mg/d). The plasma levels of monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), adiponectin and tumor necrosis factor-alpha (TNF(alpha)), the urinary excretion of 8-epi-prostaglandin F(2alpha) (8-epi-PGF(2alpha)) and 8-hydroxydeoxyguanosine (8-OHdG), and the urinary albumin-to-creatinine ratios (ACR) were determined before and after 16-week treatment. Neither metabolic parameters nor blood pressure levels differed between the two groups not only at baseline but also after the treatment. However, significant decreases in MCP-1, IL-6, hsCRP, TNF(alpha), 8-epi-PGF(2alpha), 8-OHdG and ACR levels, and a significant increase in the plasma adiponectin level were detected in the AZ group, but not in the NF group. The % change in the urinary oxidative stress markers correlated with that in ACR. Our results indicate that, in hypertensive patients with diabetic nephropathy, a combination therapy of RAS inhibitors and AZ is an effective therapeutic modality for decreasing not only blood pressure but also inflammations and oxidative stresses.     

糖尿病肾病进展与凝血异常的关系

目的 探讨糖尿病肾病(DN)患者凝血异常与尿蛋白和肾功能的关系。方法选择观察8个月期间尿蛋白和肾功能变化相一致的22例患者，分为二组，一组以华法林治疗，一组作为对照，每组各11例。每月测一次血、尿肌酐和尿蛋白，华法林停用后第2天检测各项凝血指标。结果尿蛋白增加和肾功能恶化作为2个独立因素增强DN患者的凝血活性；抗凝治疗在改善凝血亢进状态后能延缓肾功能恶化，但不减少尿蛋白排泄。结论DN患者伴随尿蛋白增加血液高凝状态加重，并因此促进肾功能恶化。     

Urinary podocyte-associated mRNA profile in Egyptian patients with diabetic nephropathy

IntroductionPodocyte injury and subsequent excretion in urine play a crucial role in the pathogenesis and progression of diabetic nephropathy (DN). Quantification of messenger RNA expression in urinary sediment by real-time PCR is emerging as a noninvasive method of screening DN-associated biomarkers. We aimed to study the expression of podocyte-associated genes in urinary sediment and their relation to disease severity in type 2 diabetic Egyptian patients with diabetic nephropathy.Methodology: Sixty patients with type 2 diabetes mellitus were recruited in addition to twenty non diabetic healthy volunteers. Relative mRNA abundance of nephrin, podocalyxin, and podocin were quantified, and correlations between target mRNAs and clinical parameters were examined.ResultsThe urinary mRNA levels of all genes studied were significantly higher in diabetics compared with controls (p < 0.001), and mRNA levels increased with DN progression. Urinary mRNA levels of all target genes positively correlated with both UAE and HbA_1c. The expression of nephrin, podocalyxin, and podocin mRNA correlated with serum creatinine {(r = 0.397, p value = 0.002), (r = 0.431, p value = 0.001), (r = 0.433, p value = 0.001) respectively}.ConclusionThe urinary mRNA profiles of nephrin, podocalyxin, and podocin were found to increase with the progression of DN, which suggested that quantification of podocyte-associated molecules will be useful biomarkers of DN.     

2型糖尿病患者血8-羟基脱氧鸟嘌呤水平与大血管并发症的关系

目的初步探讨氧化应激在2型糖尿病患者大血管并发症中的作用。方法 2型糖尿病患者78例,分为大血管并发症组(32例)和无并发症组(46例)。检测两组患者血TG、TC、LDL-C、HDL-C、糖化血红蛋白(HbAlc)和8-羟基脱氧鸟嘌呤(8-OHdG)水平。同期检测65例健康体检者(对照组)血8-OHdG水平。结果 2型糖尿病患者血8-OHdG水平明显高于对照组[(2.78±1.33)μg/L vs (0.72±0.93)μg/L,P<0.05]。大血管并发症组血8-OHdG据平较无并发症组有上升趋势,但差异无统计学意义[(2.93±1.37)μg/L vs (2.67±1.30)μg/L,P>0.05];大血管并发症组TG水平和病程明显高于无并发症组,差异有统计学意义(P<0.05)。血8-OHdG水平与TG和病程呈正相关(P<0.05),而与TC、LDL-C、HDL-C及HbAlc水平无明显相关(P>0.05)。结论 2型糖尿病患者氧化应激水平增高。2型糖尿病患者大血管并发症的发生可能与病程、血脂关系更密切,脂代谢异常是糖尿病氧化应激的重要影响因素。