MBL途径补体激活与糖尿病肾病进展的相关性研究

Correlation research about MBL complement pathway activation and progression of diabetic nephropathy

目的观察Ⅱ型糖尿病患者血清甘露聚糖结合凝集素(MBL)和尿膜攻击复合物(MAC)的表达及与糖尿病肾病发生和进展的相关性。方法选择60例Ⅱ型糖尿病患者,按照尿白蛋白排泄率(UAER)分为正常白蛋白尿组(NA,UAER<30mg/24h,n=20),微量白蛋白尿组(MA,UAER 30～300mg/24h,n=20)和临床蛋白尿组(CA,UAER>300mg/24h,n=20)。采用双抗体夹心酶联免疫吸附实验(ELISA)检测血清MBL、尿MAC水平,并检测各组患者的血清肌酐(SCr)等指标。结果 CA组血清MBL和尿MAC明显高于MA组(P<0.05),MA组也高于NA组(P<0.05);所有患者的血清MBL与尿MAC呈高度正相关关系(P<0.05);血清MBL及尿MAC与患者的UAER及血清肌酐均存在正相关关系(P<0.05)。结论 MBL途径补体激活可能与糖尿病肾病的发生及进展密切相关。

Objective To investigate the expression of serum mannose-binding lectin （MBL） and urinary mem- brane attack complex （MAC） in type 2 diabetics and their correlation with onset and progression of diabetic nephropathy. Methods 60 patients with T2DM were divided into three groups according to their urinary albumin excretion rate （UAER）.. normal albuminuria group （NA, UAER〈0mg/24h, n=20）, micro-albuminuria group （MA, UAER 30- 300mg/24h, n=20） and clinical proteinuria group （CA, UAER〉300mg/24h, n=20）. Double antibody sandwich en-zyme-linked immunosorbent assay （ELISA） was used to detect serum MBL and urine MAC, serum creatinine （SCr） and other test index were also detected in each group of patients, Results Serum MBL and urine MAC were significantly higher in CA group than in MA group （P〈0.05）. They were also higher in MA group than in NA group （P〈0.05） ; In all patients, serum MBL was positively correlated with urinary MAC （P〈0.05） ; both serum MBL and urine MAC were positively correlated with UAER and serum creatinine （P〈0.05）. Conclusion MBL complement pathway activation may be closely correlated with the onset and progression of diabetic nephropathy.