尿Ⅳ型胶原检测对早期糖尿病肾病临床诊断意义的研究

Urinary Type Ⅳ Collagen as Biochemical Test Marker in Patients with Diabetic Nephropathy In Early Stage

目的 :研究尿Ⅳ型胶原在糖尿病肾病 (DN)早期肾损害时的变化及与其他相关指标之间的关系。方法 :采用一步夹心酶联免疫吸附法对 85例糖尿病患者及 2 4例正常成人尿Ⅳ型胶原水平进行检测。结果 :正常白蛋白尿组尿Ⅳ型胶原水平明显高于正常对照组 (P <0 0 1) ;微量白蛋白尿组和大量白蛋白尿组尿Ⅳ型胶原水平明显高于正常白蛋白尿组 (P均 <0 0 1) ;尿Ⅳ型胶原水平与尿白蛋白及病程之间存在显著的正相关 ,尿Ⅳ型胶原水平与血糖、体重指数、血脂及血压之间无相关性。结论 :DN存在着胶原代谢的异常。尿Ⅳ型胶原在DN肾损害早期明显增高 ,并随病情进展持续性增高 。

Objective: Our purpose was to investigate the change of urinary type Ⅳ collagen in early stage of diabetic nephropathy(DN) and its possible relationship with the correlated markers. Methods:Urinary type Ⅳ collagen was determined with one-step sandwich enzyme immunoassay (EIA) in 85 diabetic patients, including 31 cases of normal albuminuria(DM1 group),42 of microalbuminuria (DM2 group),12 of overtalbuminuria(DM3 group) and 24 healthy subjects as control.Results:The mean concentration of urinary type Ⅳ collagen in DM1 group(9.43±8.79 μg/g·cr) was significantly higher than that of control(3.44±0.11μg/g·cr,P<0.01).The levels of urinary type Ⅳ collagen in patients in DM2 or DM3 group, which were (23.33±16.40) μg/g·cr and (61.23±30.73) μg/g·cr, were significantly higher than that in DM1 group (P<0.01). There was a significant correlation between the concentration of urinary type Ⅳ collagen and urinary albumin, as well as diabetic duration. There was no correlation between urinary type IV collagen and TC, TG, SBP, DBP, BMI, and blood sugar. Conclusion:Abnormal collagen metabolism exists in patients with diabetic nephropathy. The level of urinary type Ⅳ collagen has largely increased in early renal lesion stage in diabetic nephropathy.Therefore, it could be an early and sensitive marker of DN.