不同尿白蛋白排泄率的2型糖尿病患者血清Smad2和Smad7的变化及临床意义

The clinical significance and levels of serum Smad2 and Smad7 in type 2 diabetes with different urinary albumin excretion rate

目的探讨不同尿白蛋白排泄率的2型糖尿病患者血清Sm ad2和Sm ad7的变化及临床意义。方法对203例2型糖尿病患者根据尿蛋白排泄率(U AER)(尿白蛋白与尿肌酐的比值,urinary album in tocreatinine ratio,AC R)分为正常白蛋白尿组(D 1组78例)、微量白蛋白尿组(D 2组69例)、临床白蛋白尿组(D 3组56例),分别测定血清Sm ad2和Sm ad7的水平及代谢指标,并与41例正常对照者相比较。结果 2型糖尿病患者中血清Sm ad2和Sm ad7的水平显著高于对照组,D 3和D 2组的血清Sm ad2和Sm ad7显著高于D 1组,D 3组血清Sm ad2和Sm ad7的水平显著高于D 2组;2型糖尿病患者血清Sm ad2和Sm ad7的水平与AC R、糖化血红蛋白(H bA1c)成显著正相关(P<0.05),与空腹血糖(FBG)及空腹胰岛素(FIN S)无统计学相关性。结论Sm ad2和Sm ad7可能参与糖尿病肾病(diabetic kidney disease,D KD)的发生发展,检测血清中Sm ad2水平对于D KD的诊断及其干预有重要意义。

【Objective】 To study the clinical significance and levels of serum Smad 2 and Smad 7 in type 2 diabetes with different urinary albumin excretion rate.【Methods】 One hundred and thirteen patiesnts with type 2 diabetes were selected for this study.The patients were divided into three group according to urinary albumin excretion rate（UEAR）（urinary albumin to creatinine ratio,ACR）： 43 patients with normal UAER were D1 group,39 patients with microalbuminuria were D2 group,31 patients with clinical albuminuria were D3 group.The level of serum Smad2,Smad7 and other metabolism were measured and those of 41 normal control subjects at the same time.【Results】 Compared with normal control group,levels of Smad2 and Smad 7 were significantly higher;Compared with normal albuminuria group,levels of Smad2 and Smad 7 in microalbuminuria group and clinical albuminuria group were significantly higher;Levels of Smad2 and Smad7 in clinical albminuria group were higher than that of microalbuminuria group.The levels of Smad2 and Smad7 were positively correlated with ACR and HbA1C respepectively,and had no significant correlation with fasting plasma glucose（FPG） and fasting insulin（FINS）.【Conclusion】 These results suggest that serum Smad 2 and Smad 7 may be involved in the progression of Diabetic kidney disease（DKD）.Measuring level of Smad 2 and Smad 7 are very important in the diagnosis and intervention of early DKD.