2型糖尿病抗α_1和β_1受体自身抗体与尿白蛋白排泄率的相关性研究

The correlation between the autoantibodies against β1and α1-adrenergic receptor and urinary albumin excretion rate in type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者血清抗α1和β1受体自身抗体与白蛋白尿的关系。方法根据尿白蛋白排泄率(UAER)将201例T2DM患者分为:正常白蛋白尿(N-UAlb)组71例,微量白蛋白尿(M-UAlb)组79例,临床白蛋白尿(C-UAlb)组51例。40名正常人为正常对照(NC)组。以合成的α1和β1受体多肽片段为抗原,应用酶联免疫吸附(ELISA)技术,检测四组血清中抗G-蛋白偶联型α1和β1受体自身抗体。结果 (1)M-UAlb+C-UAlb组患者血清抗α1和β1受体自身抗体阳性率分别为52.3%和51.5%,明显高于N-UAlb组的12.7%和15.5%及NC组的12.5%和10.0%,差异均有统计学意义(P均<0.05)。(2)C-UAlb组抗α1和β1受体自身抗体阳性率分别为68.6%和70.6%,明显高于M-UAlb组的41.8%和39.2%,M-UAlb组明显高于N-UAlb组,差异均有统计学意义(P均<0.01)。结论血清抗α1和β1受体自身抗体阳性率与白蛋白尿有关,在糖尿病并发肾损害中起重要作用。

Objective To explore relation of the positive rates of the autoantibodies against α1 and β1-adrenergic receptor with urinary albumin excretion rate in type 2 diabetes mellitus. Methods The epitopes of the second extracellular loop of β1 receptor（197-222）and α1-receptor（192-218）were synthesized and used respectively to screen several autoantibodies of patients with type 2 diabetes mellitus（n= 201）and healthy volunteers（n=40, control）. UAER〈20μg/min as A group（n= 71）, UAER 20 - 200μg/min as B group（n= 79）, and UAER〉200μg /min as C group（n= 51）were included. UAER was detected by enzyme-linked immunosorbent assay（ELISA）. Results （1） The positive rates of the autoantibodies were 52.3 % （68/130）against α1-receptors and 51.5% （68/130） against β1 receptor in B group plus C group,which were higher than in A group and in volunteers. （2）In group C versus group B, antibody against α1 was higher （68.6% vs 41.8%） ,Ab against β1 was higher（70. 6% vs 39.2%）. In group B versus A group,antibodies against α1 ,and β1 were higher（41.8% vs 12.7% for α1 ;39.2% vs 15.5% for β1）. Conclusions Autoantibodies against α1 and β1 receptor may play an important role in the pathogenesis of diabetic nephropathy.