阿托伐他汀对早期糖尿病肾病老年患者外周血NF-κB和尿白蛋白排泄率的影响

Effects of atorvastatin on the activity of nuclear factor-kappa B in peripheral blood mononuclear cells and urinary albumin excretion rate in elderly patients with early diabetic nephropathy

目的:观察阿托伐他汀对早期糖尿病肾病老年患者外周血单个核细胞中核因子-κB(NF-κB)P65(Ser536)的磷酸化水平和血清hs-CRP、TNF-α、IL-6、IL-1β等炎症指标,以及UAER的影响。方法:设对照组(NC组,n=30),66例2型糖尿病早期肾病老年患者随机分为糖尿病常规治疗组(DN1组,n=31)及糖尿病常规治疗联合阿托伐他汀干预组(DN2组,n=35)。观察3组炎症指标,比较DN1组、DN2组治疗前后炎症指标、UAER的变化。结果:糖尿病患者外周血NF-κBP65(Ser536)水平显著高于对照组(0.95±0.18vs0.47±0.15,P<0.01),血清hs-CRP、TNF-α、IL-6、IL-1β水平明显高于对照组(P<0.01)。治疗12周后,DN2组炎症指标、UAER明显降低(P<0.01),NF-κB水平由0.95±0.17降至0.81±0.14(P<0.01)。DN1组无显著下降(P>0.05)。结论:阿托伐他汀可降低糖尿病肾病患者炎症水平,减少尿白蛋白,延缓肾损害的发展进程。

Objective To observe the effects of atorvastatin on the phosphorylation of nuclear factor- kappa B （NF-KB） P65 （Ser536） in peripheral blood mononuclear cells, and on the levels of serum inflammatory factors, including high sensitivity C reactive protein （hs-CRP）, tumor necrosis factor-α（TNF-α）, interleukin-6 （IL-6）, and interleukin-1β（IL-1β）, and on urinary albumin excretion rate （UAER） in elderly patients with early diabetic nephropathy. Methods There were 30 control subjects （NC group, n = 30） and 66 elderly patients with type 2 diabetics and early diabetic nephropathy in this study. Sixty-six patients were randomly divided into 2 group： routine treatment group （DN1 group, n = 31 ） and routine treatment plus atorvastatin intervention group （DN2 group, n = 35）. Inflammatory markers were observed in the three groups. Changes of inflammatory markers and UAER were observed and compared between DN1 and DN2 group. Results As compared with those in control subjects, levels of NF-KB were higher in patients with diabetics （0.95 ±0.18 vs. 0.47 ± 0.15, P 〈 0.01）, and levels of hs-CRP, TNF-α, IL-6, and IL-1β were significantly higher in patients with diabetics （P 〈 0.01）. After 12 weeks of treatment, levels of inflammatory markers and UAER were significantly decreased in DN2 group （P 〈 0.05）, and level of NF-κB was decreased from 0.95 ± 0.17 to 0.81 ± 0.14 （P 〈 0.05）. There was no significant changes in DN1 group （P 〉 0.05）. Conclusion Atorvastatin may benefit patients with diabetes mellitus by ameliorating inflammatory state, as well as reducing urinary albumin and decelerating deterioration of renal function.