血浆纤溶酶原激活物抑制物1及血清转化生长因子β与2型糖尿病肾病的相关性研究

目的 研究2型糖尿病肾病(DN)及单纯2型糖尿病(T2DM)患者血浆纤溶酶原激活物抑制物1(PAI-1)及血清转化生长因子β(TGF-β)水平的变化.并进一步探讨在T2DM患者中血浆PAI-1和血清TGF-β的关系.方法 T2DM患者93例,其中T2DM无蛋白尿患者(DM组)37例；微量蛋白尿患者(DN 1组)27例,尿白蛋白/肌酐(A/C)20～200 mg/g;显著蛋白尿患者(DN 2组)29例,A/C＞200 mg/g.选取正常对照组32例,均为健康体检者.所有检测对象过夜禁食10～12小时后,于清晨空腹抽取肘静脉血4 ml,其中2 ml不抗凝血用于生化指标检测.酶联免疫吸附试验(ELISA)测定血浆PAI-1、TGF-β水平.结果 ①血浆PAI-1水平DN1、DN2组显著高于正常对照组,(69.28±18.61) ng/L、(69.43±17.86) ng/L vs (51.97±30.11) ng/L(P＜0.05).②血清TGF-β水平DM、DN1、DN2组显著高于正常对照组,分别为(137.99±21.47) ng/L、(180.36±40.45) ng/L、(298.92±77.37) ng/L vs(100.65±24.21) ng/L(均P＜0.01).③血清TGF-β和血浆PAI-1水平无明显相关性.④血浆PAI-1水平及血清TGF-β水平升高是T2DM并发肾病的危险因素.结论 T2DM合并肾病患者血浆PAI-1水平、血清TGF-β水平升高,两项指标可以预测T2DM合并肾病的危险.

Correlation of plasminogen activator inhibitor-1 and transforming growth factor-beta with diabetic nephropathy in type 2 diabetes mellitus

Objective Plasma plasminogen activator inhibitor-1（PAI-1） and transforming growth factor-beta（TGF-β） level of type 2 diabetes patients were studied for exploring the pathophysiological mechanism.Methods According to the standards of diabetic diagnosis and typing put forward by ADA in 1997,a total of 93 unrelated patients with type 2 diabetes were randomly recruited in the study.These patients were further divided into type 2 diabetes with nephropathy（DN1、DN2） and without nephropathy（DN） according to their urinary albumin to creatinine ratio（A/C）.At the same time,32 healthy controls were selected from population for regular physical examination in the hospital.The levels of PAI-1 and TGF-β were measured by enzyme-linked immunosorbent assay（ELISA）.Results ①The plasma PAI-1 levels in DN1 and DN2 group were higher than that in healthy controls,（69.28±18.61） ng/L,（69.43±17.86） ng/L vs（51.97±30.11） ng/L（P0.05）.② The levels of TGF-β in DM,DN1 and DN2 group were higher than that in healthy controls,（137.99±21.47） ng/L,（180.6±40.45） ng/L,（298.92±77.37） ng/L vs（100.65±24.21） ng/L（all P0.01）.③The level of plasma PAI-1 was not related to the level of TGF-β.④The higher level of PAI-1 and TGF-β were risk factors of type 2 diabetes nephropathy.Conclusion In type 2 diabetes or complicated nephropathy patients,the levels of PAI-1 and TGF-β are higher,both items can predict type 2 diabetes nephropathy.