2型糖尿病患者肝细胞生长因子与转化生长因子β1的测定及其意义

The changes and their clinical siganificances of liver cell growth factor and transforming growth factor-β1 of type Ⅱ diabetes

目的探讨血清肝细胞生长因子（HGF）、转化生长因子β1（TGF-β1）、基质金属蛋白酶-2（MMP-2）、MMP-9及金属蛋白酶抑制物-1（TIMP-1）在糖尿病不同肾损害期中的差异及其临床意义。方法将113例2型糖尿病患者根据尿微量白蛋白含量分为正常白蛋白尿组（NA组）38例、微量白蛋白尿组（MA组）40例和大量自蛋白尿组（CP组）35例，同时随机分为糖耐量受损（IGT）组40例和正常对照（NC）组30例，并采用ELISA法检测血清HGF、TGF-β1、MMP-2、MMP-9、TIMP-1和Ⅳ型胶原（IVC）含量。结果IGT组和NA组HGF含量显著高于NC组（P〈0.01），而MA组与CP组含量显著低于NC组（P〈0．01），以CP组含量最低；NA、MA和CP组TGF—β1含量显著高于NC组与IGT组（均P〈0．01），以CP组含量最高；2型糖尿病3组间HGF和TGF-9、含量的差异均有统计学意义（P〈0.01或0.05）；CP组和MA组MMP-2、MMP-9含量显著低于NC、IGT及NA组（P〈0．01），而TIMP-1与IVC含量显著高于NC、IGT和NA组（均P〈0.01）。结论糖尿病不同肾损害期患者存在HGF与TGF—β1、及MMP／TIMP系统的失衡，与糖尿病肾病的进展有关。

Objective To study the changs and siganificances of serum liver cell growth factor （HGF）, transforming growth factor- β1 （TGF-β1）, matrix metalloproteinase （MMP-2,MMP-9）, Tissue inhibitors of metalloproteinase-1 （TIMP-1）of type Ⅱ diabetes at different times of nephritic damage. Methods According to urine albumin ejection rate （UAER） 113 patients with type Ⅱ diabetes were divided into group with normal urine albumin including 38 （NA）,group with minor urine albumin including 40 （MA）and group with clinical urine protein including 35 （CP）. Our study also included 40 patients with impaired glucose tolerance （IGTand 30 normal controls （NC）.The serum TGF- β1, HGF, MMP-2, MMP-9 and TIMP-1 were tested by ELISA. Results The HGF of IGT and NA were both obviously higher than that of NC （P〈0.01）the HGF of MA and CP were both clearly lower than that of NC（ P〈 0.01）,furthermore ,the HGF of CP was obviously lower than that of MA（ P〈 0.01）.The TGF- β1 of all kinds of groups with type Ⅱ diabetes were all siganificantly higher than those of NC and IGT （ P〈 0.01）. The levels of MMP-2 and MMP-9 in CP or MA group were lower obviously than those in NC, IGT and NA group, but the levels of TIMP-1 and IVC showed higher obviously （P〈0.01）. Conclusion The unbalances between HGF and TGF - β1 or MMP/TIMP system of type Ⅱdiabetes at different times of nephritic damage were possibly related with the forming of diabetic nephropathy.