吡格列酮对糖尿病肾病患者血清AGEs和RANTES水平的影响

Effects of Pioglitazone on the Serum AGEs and RANTES in the Patients with Diabetic Nephropathy

目的探讨吡格列酮对糖尿病肾病患者血清糖基化终产物-肽(AGE-P)及受活化调节、由正常T细胞表达和分泌的趋化蛋白(RANTES)的影响。方法2型糖尿病伴微量白蛋白尿患者50例,分别接受格列吡嗪控释片(瑞易宁)和吡格列酮治疗6月,流动注射分析法检测血清AGE-P水平,ELISA法检测RANTES水平。结果(1)2组患者治疗后AGE-P水平均有下降,吡格列酮组AGE-P水平下降程度大于瑞易宁组;(2)吡格列酮组治疗后RANTES水平下降,且下降程度大于瑞易宁组;(3)吡格列酮组尿微量白蛋白下降值(ΔUMA)分别与治疗后血清RANTES下降值(ΔRANTES)、治疗后AGE-P下降值(ΔAGE-P)呈明显正相关;血清ΔAGE-P与血清ΔRANTES也呈正相关。结论吡格列酮可减少尿微量白蛋白(UMA)排泄,降低2型糖尿病肾病患者血清AGE-P和RANTES水平。

Objective To investigate the effect of pioglitazone on the serum AGE-P and RANTES in the patients with diabetic nephropathy. Methods 50 type 2 diabetic patients with microalbuminuria. （UMA/ereatinine 30-300 μg/mg） were treated with pioglitazone or glipizide, respectively. The serum RANTES concentration was measured by enzyme-linked immunosorbent assay （ELISA）. The serum AGE-P concentration was measured by flow injection assay. Results （1） The levels of AGE-Pin the pioglitazone group were significantly lower than those in the glipizide group. （2） The levels of RANTES in the pioglitazone group were lower than those in the glipizide group as well. （3） The levels of AUMA were correlated positively with the levels of △AGE-P and the levels of △RANTES. The levels of ARANTES was also correlated positively with the levels of △AGE-P. Conclusions Pioglitazone diminished the levels of UMA, and may reduces the serum AGE-P and RANTES levels elevated in the patients with type 2 diabetic nephropathy.