1,25-二羟维生素D3对糖尿病肾病患者尿足细胞相关蛋白Nephrin的影响

Effects of 1,25-dihydroxyvitamin D3 on the expression of urinary nephrin in diabetic nephropathy patients

目的探讨1,25-二羟维生素D3(1,25-(OH)2D3)对糖尿病肾病(DN)患者尿足细胞相关蛋白Nephrin的影响。方法选取DN患者共40例,根据尿清蛋白排泄率(UAER)水平分为微量清蛋白尿的DN1组22例和大量清蛋白尿的DN2组18例,经6周洗脱期后给予1,25-(OH)2D3 0.25μg/d,共治疗12周,10例健康体检者为对照组,测定各组人群血钙(Ca2+)、血磷(P3+)、血肌酐(Scr)及24h尿蛋白及VAER,采用定量酶联免疫吸附法(ELISA)测定各组观察人群尿液中Nephrin的表达。结果 DN组患者尿中Nephrin表达明显多于对照组,DN1组与DN2组间尿中Nephrin表达也存在差异,1,25-(OH)2D3可使DN1组患者尿中Nephrin表达基线下移(P<0.05),但对DN2组患者尿中Nephrin表达无明显影响(P>0.05)。结论尿中Nephrin的表达是预测DN进展的有效因子,1,25-(OH)2D3可减少早期DN患者尿中Nephrin表达从而减少蛋白尿,延缓DN进展。

Objective To investigate the effects of 1 ,25-dihydroxyvitamin D3 on the expression of urinary Nephrin in patients with diabetic nephropathy .Methods According to albumin excretion rate ,40 type-2 diabetic nephropathy patients were divided into 2 groups ,10 healthy volunteers served as control .The treatment groups received 1 ,25-dihydroxyvitamin D3 0.25 μg/d for 12 weeks .The levels of blood calcium ,phosphorus ,serum creatinine ,24-hour urinary protein excretion were detected .Enzyme-linked immunosorbent assay was used to detect urinary Nephrin in different groups .Results The expressions of urinary Nephrin were sta-tistically different among NC group ,DN1 group and DN2 group .1 ,25-dihydroxyvitamin D3 treatment significantly decreased the ex-pression of urinary Nephrin in DN1 patients ,whereas no statistically changes were observed in DN2 group .Conclusion In diabetic nephropathy patients ,urinary Nephrin is supposed to be effective an marker of disease progression .1 ,25-dihydroxyvitamin D3 may be effective to prevent podocyte injury in early-stage diabetic nephropathy .