2型糖尿病肾病患者血清细胞粘附分子变化与氧化应激的关系

The relationship between soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 levels and oxidative stress in patients with diabetic nephropathy

目的 探讨 2型糖尿病肾病患者 (DN)血清细胞粘附分子变化及其与氧化应激的关系。 方法 检测DN患者血清可溶性细胞间粘附分子 1(sICAM 1)、可溶性血管细胞粘附分子 1(sVCAM 1)、血清丙二醛 (MDA)含量和超氧化物歧化酶 (SOD)活性。 结果 早期DN及DN患者血清sVCAM 1水平〔分别为 (1 75± 0 48)、(1 91± 0 2 7)mg/L〕明显高于对照组〔(1 6 7± 0 72 )mg/L ,P <0 0 5和0 0 1〕 ,DN组明显高于单纯糖尿病 (DM)组〔(1 5 8± 0 39)mg/L ,P <0 0 5〕 ;DM组、早期DN组和DN组患者血清sICAM 1〔分别为 (75 6 0 0± 12 5 47)、(80 2 2 1± 12 4 81)、(897 6 0± 10 5 80 ) μg/L〕明显高于对照组〔(5 82 6 4± 10 2 73) μg/L ,P <0 0 0 1〕 ,其中DN组明显高于单纯DM组和早期DN组 (分别P <0 0 1和<0 0 5 ) ;单纯DM组、早期DN组和DN组患者血清SOD活性〔分别为 (86 5 9± 13 85 )、(85 6 9±11 32 )、(71 73± 16 35 )NU/L〕显著性低于对照组〔(92 73± 11 2 5 )NU/ml,P <0 0 1〕 ,MDA含量〔分别为(3 99± 1 36 )、(4 2 6± 1 95 )、(6 5 0± 2 98)nmol/ml〕显著性高于对照组〔(3 72± 0 5 7)nmol/ml,P <0 0 1〕。DM患者血清sVCAM 1与sICAM 1、收缩压、尿素氮 (BUN)和肌酐 (Cr)呈正相?

Objective To investigate the relationship between the levels of soluble intercellular adhesion molecule-1(sICAM-1), vascular cell adhesion molecule-1(sVCAM-1) and oxidative stress in patients with diabetic nephropathy (DN). Methods Sixty-eight patients with type 2 diabetes mellitus (DM) were divided into 3 groups according to the value of urinary albumin excretion rate (UAER). (1) Simple DM group (SDM), UAER<30 mg/24 h, 24 cases; (2) early diabetic nephropathy (EDN), UAER 30-300 mg/24 h, 34 cases; (3) clinical diabetic nephropathy(CDN), UAER≥300 mg/24 h, 10 cases. The levels of sVCAM-1, sICAM-1, the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA) were measured in the type 2 DM patients of 3 groups and 30 normal controls (NC group). Results The levels of sVCAM-1 were higher in DN 〔(1.75±0.48) and (1.91±0.27)mg/L 〕 than in NC group〔(1.67±0.72)mg/L,P<0.05, P<0.01〕. The levels of sVCAM-1 in CDN group was significantly higher than that in SDM 〔(1.58±0.39)mg/L,P<0.05). The levels of sICAM-1 were more markedly elevated in SDM, EDN and CDN groups〔(756.00±125.47),(802.21±124.81) and (897.60±105.80)μg /L〕than in NC group〔(582.64±102.73)μg /L,P<0.001) and that for CDN group was significantly higher than that for SDM and EDN groups (P<0.01, P<0.05). The activity of SOD in SDM, EDN and CDN groups 〔(86.59±13.85),(85.69±11.32) and (71.73±16.35 )NU/ml 〕 was significantly lower than those in NC group 〔(92.73±11.25)NU/ml, P<0.01〕; the content of MDA was significantly elevated in SDM, EDN and CDN groups 〔(3.99±1.36) ,(4.26±1.95) and (6.50±2.98) nmol/ml〕 compared with those in NC group 〔(3.72±0.57)nmol/ml, P<0.01, P<0.001〕. There was significant positive correlation between sVCAM-1 and sICAM-1, systolic pressure, BUN, Cr. The level of sICAM-1 was positively correlated with BUN, Cr, UAER, MDA and sVCAM-1 in DM. Conclusions The levels of sICAM-1 and sVCAM-1 are significantly elevated in DN. Oxidative stress may participate in determinining the sICAM-1 level in DN. Antioxidant treatment can prevent the progression of DN.