2型糖尿病肾病患者血清脂联素、血管内皮生长因子水平与氧化应激的相关性

目的:探讨2型糖尿病肾病(DN)不同阶段血清脂联素(APN)、血管内皮生长因子(VEGF)变化及其与氧化应激的关系.方法:将符合1999年WHO诊断标准的2型糖尿病患者根据24 h尿蛋白排泄率分为3组,即正常白蛋白尿组(SDM)、微量白蛋白尿组(NA)、大量蛋白尿组(MA).另设正常对照组(NC).采用双抗夹心ELISA法检测DN患者血清APN、VEGF水平,采用比色法测定超氧化物歧化酶(SOD)活性及丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)含量.结果:①DN患者血清APN水平低于正常对照组；DN患者各组间比较,大量蛋白尿组的血清APN水平最低,差异有统计学意义(P＜0.05)；血清VEGF水平在NA、MA组明显高于SDM组和NC组,差异有统计学意义(P＜0.05).②与NC组比较,SOD活性及GSH-Px水平在糖尿病各组明显下降(P＜0.01),MDA水平在NA组、MA组明显升高(P＜0.01).③糖尿病患者血清APN与UAER、MDA、VEGF浓度呈负相关(P＜0.05),与SOD、GSH-Px呈显著正相关(P＜0.01)；血清VEGF浓度与病程、HbAlc、UAER、MDA的升高呈正相关(P＜0.05),与SOD、GSH-Px呈显著负相关(P＜0.01).结论:DN患者血清APN、VEGF水平与氧化应激密切相关,低APN血症是2型糖尿病及DN发生的危险因素,VEGF升高可能是DN的危险因素.

Association of Serum Adiponection and Vascular Endothelial Growth Factors with Oxidative Stress in Type 2 Diabetic Nephropathy

Objective: To investigate the association of serum adiponection(APN) and vascular endothelial growth factors(VEGF) with oxidative stress in different stages of diabetic nephropathy.Methods: Twenty-five healthy subjects(NC) and 105 patients with type 2 diabetes mellitus,which were sub-divided into three groups according to their uriary albumin excretion rate(UAER) as: normal UAER group(SDM group,n=35),microalbuminuria group(NA group,n=35),and clinical proteinuria group(MA group,n=35).Serum APN and VEGF were measured by ELISA,and superoxide dismutase(SOD),serum malondialdehyde(MDA) and glutathione peroxidase(GSH-Px) were determined by chemical chromatometry.Results: ①The level of serum APN was lower in diabetic nephropathy patients than in NC group(P<0.05).Among diabetic patients,the serum APN in MA group was significantly lower than that in SDM and NA groups(P<0.05);the serum VEGF in NA and MA groups were significantly higher than that in NC and SDM groups(P<0.05).②As compare with that respectively in NC group,the activity of SOD and serum GSH-Px level in the three diabetic groups were significantly lower(P<0.01).Serum MDA level was increased significantly in NA and MA groups(P<0.01).③For the patients,serum APN was negatively correlated with UAER,MDA,and VEGF(P<0.05),and positively correlated with SOD and GSH-Px(P<0.01).Serum VEGF was positively correlated with duration of disease,HbA1c,UAER,and MDA(P<0.05),and negatively correlated with SOD and GSH-Px(P<0.01).Conclusion: In patients with diabetic nephropathy,serum APN and VEGF were correlated with SOD and other oxidative stress indices.Lower serum APN was a risk factor to diabetes and diabetic nephropathy,while elevated VEGF may be a risk factor of the onset of diabetic nephropathy.