血清血管生成抑制蛋白1在2型糖尿病肾病中的表达及临床意义

Expression and Clinical Significance of Serum Vasohibin-1 in Type 2 Diabetic Nephropathy

目的:探讨2型糖尿病肾病(DN)患者血清血管生成抑制蛋白1(VASH-1)的表达变化及临床意义。方法:选取252例DN患者作为研究组,根据尿白蛋白排泄率(UAER)情况将其分为正常白蛋白尿组(NA组,n=83)、微量白蛋白尿组(MA组,n=85)和大量白蛋白尿组(LA组,n=84),另选取同期健康体检者85例作为对照组,收集24h尿行UAER检测,采集静脉血行VASH-1、转化生长因子β1(TGF-β1)、C-反应蛋白(CRP)、糖化血红蛋白(HbA1c)和血沉(ESR)检测,比较各组VASH-1、TGF-β1、UAER、CRP、HbA1c和ESR水平的变化,并分析VASH-1与其他指标间的相关性。结果:研究组患者VASH-1、TGF-β1、UAER、CRP、HbA1c、ESR水平明显高于对照组,两组间比较具有统计学意义(P<0.05)。NA组、MA组和LA组VASH-1、TGF-β1、CRP、HbA1c、ESR水平为:LA组>MA组>NA组,三组间比较均具统计学意义(P<0.05)。Pearson相关性分析示:DN患者VASH-1与TGF-β1、UAER、CRP、HbA1c、ESR间呈正相关性(r=0.526、0.646、0.529、0.273、0.592,P<0.01)。多元线性回归分析发现:TGF-β1、UAER、CRP、HbA1c、ESR水平变化是影响DN患者血清VASH-1水平变化的独立危险因素。结论:血清VASH-1在DN患者中表达水平升高,与TGF-β1及炎症标志物关系密切,为糖尿病患者肾脏损伤中发生的炎症及纤维化机制研究、辅助诊断、治疗靶点探讨和新的药物研发提供了新的思路。

Objective:To investigate the expression and clinical significance of serum vasohibin-1(VASH-1)in patients with type 2 diabetic nephropathy(DN).Methods:252 patients with DN were selected as the research group for prospective study.According to the urinary albumin excretion rate(UAER),they were divided into normal albuminuria group(NA group,n=83),microalbuminuria group(MA group,n=85)and large albuminuria group(LA group,n=84).85 healthy people in the same period were selected as the control group.24 hours urine was collected for UAER detection,and venous blood was collected for VASH-1,transforming growth factor-β1(TGF-β1),C-reactive protein(CRP),glycosylated hemoglobin(HbA1c)and erythrocyte sedimentation rate(ESR)detection,which were compared among the groups,and the correlation between VASH-1 and other indexes was analyzed.Results:The levels of VASH-1,TGF-β1,UAER,CRP,HbA1c and ESR in the research group were significantly higher than those in the control group.The comparison between the two groups was statistically significant(P<0.05).The levels of research in NA group,MA group and LA group were as follows:LA group>MA group>NA group;the comparison among the three groups was statistically significant(P<0.05).Pearson correlation analysis showed that VASH-1 was positively correlated with TGF-β1,UAER,CRP,HbA1c and ESR(r=0.526,0.646,0.529,0.273,0.592,P<0.01).Multiple linear regression analysis showed that TGF-β1,UAER,CRP,HbA1c and ESR were independent risk factors for the change of serum VASH-1 level in DN patients.Conclusion:The increased expression of serum VASH-1 in DN patients is closely related to TGF-β1 and inflammatory markers,which provides a new way to study the mechanism of inflammation and fibrosis,to assist diagnosis,to explore therapeutic targets and to develop new drugs in diabetic renal injury.