降钙素基因相关肽、内皮素与2型糖尿病肾病的相关性研究

The correlation of calcitonin gene-related peptide and endothelin with type 2 diabetic nephropathy

目的探讨血浆降钙素基因相关肽(CGRP)和内皮素(ET)在2型糖尿病肾病患者的变化趋势,初步探讨CGRP、ET与糖尿病发病机制之间的关系。方法25例健康对照组和83例2型糖尿病患者纳入本研究。根据尿清蛋白排泄率(UAER)将糖尿病患者分为正常清蛋白尿组(28例)、微量清蛋白尿组(29例)和临床清蛋白尿组(26例)。采用放射免疫法分析进行血浆CGRP和ET含量检测。结果2型糖尿病及糖尿病肾病患者血浆ET值较健康对照组显著升高(P<0.01),且与UAER呈正相关(r=0.65,P<0.01);糖尿病肾病患者CGRP较对照组明显下降(P<0.05或P<0.01),且与UAER呈负相关(r=-0.71,P<0.01),ET与CGRP呈显著负相关(r=-0.62,P<0.01)。结论CGRP与ET水平的失衡参与了糖尿病肾病的发生、发展,导致了肾功能恶化。在糖尿病早期,维持CGRP和ET的动态平衡有利于防治糖尿病肾病的发生、发展。

Objective To investigate the tendency of plasma levels of calcitonin gene-related peptide （CGRP） and endothelin （ET） in type 2 diabetic nephropathy, and explore the relationship between calcitonin gene-related peptide, endothelin and pathogenesis of diabetic nephropathy. Methods A total of 25 healthy controls （healthy control group） and 83 patients with type 2 diabetic mellitus （T2DM group） were enrolled in the investigation. According to level s of urinary albumin excretion rate （UAER）, the 83 T2DM patients group were further divided into three subgroups：normal UAER subgroup （n=28）, microalbuminuira subgroup （n=29） and clinical proteinuria subgroup （n=26）. Plasma contents of calcitonin gene related peptide and endothelin were measured with radioimmunoassay （RIA）. Results The level of ET was significantly higher in T2DM group than that in healthy control group （P〈0.01）, positively correlative to UAER （r = 0. 65, P〈 0.01 ）. The plasma level of CGRP was significantly lower in the patients with diabetic nephropathy than the healthy controls, negatively correlative to UAER （r=- 0.71, P〈0.01）. There was negative correlation between plasma levels of ET and CGRP （r=-0.62, P〈0. 01）. Conclusion The disequilibrium of CGRP and ET in plasma might play an important role in the process of diabetic nephropathy. Therefore, keeping balance of levels of CGRP and ET in plasma contributes to prevention and cure of diabetic nephropathy.