CAJ | 학술논문

目的探讨血清转化生长因子β1(TGF-β1)与早期糖尿病肾病的相关性,同时阐明缬沙坦能否通过降低TGF-β1的水平发挥肾脏保护作用.方法 30例体检健康者作为对照组,66例合并糖尿病肾病的2型糖尿病患者分为正常白蛋白尿1组[尿微量白蛋白(UMA)/肌酐(Cr)<10μg/mg]12例、正常白蛋白尿2组(UMA/Cr 10～30 μg/mg)19例和微量白蛋白尿组(UMA/Cr 31～300μg/mg)35例,伴有高血压者应用缬沙坦80 mg/d共4周.分别采血测定血清TGF-β1等指标.结果正常白蛋白尿1组、正常白蛋白尿2组、微量白蛋白尿组患者血清TGF-β1水平分别为(7.41±2.68)、(10.52±4.10)、(22.98±43.74)ng/L,与对照组的(4.25±5.82)ng/L比较均明显升高(P<0.05),三组间比较差异也均有统计学意义(P<0.05),正常白蛋白尿1组中应用缬沙坦者血清TGF-β1水平较未用缬沙坦者明显下降[(5.77±1.90)ng/L比(8.23±8.78)ng/L](P<0.05),其余两组应用缬沙坦者较未用缬沙坦者血清TGF-β1水平无明显下降.结论血清TGF-β1水平升高与糖尿病及早期糖尿病肾病相关,早期应用缬沙坦可能通过降低血清TGF-β1的水平延缓糖尿病肾病的发生和发展.
목적 탐토혈청전화생장인자β1(TGF-β1)여조기당뇨병신병적상관성,동시천명힐사탄능부통과강저TGF-β1적수평발휘신장보호작용.방법 30례체검건강자작위대조조,66례합병당뇨병신병적2형당뇨병환자분위정상백단백뇨1조[뇨미량백단백(UMA)/기항(Cr)<10μg/mg]12례、정상백단백뇨2조(UMA/Cr 10～30 μg/mg)19례화미량백단백뇨조(UMA/Cr 31～300μg/mg)35례,반유고혈압자응용힐사탄80 mg/d공4주.분별채혈측정혈청TGF-β1등지표.결과 정상백단백뇨1조、정상백단백뇨2조、미량백단백뇨조환자혈청TGF-β1수평분별위(7.41±2.68)、(10.52±4.10)、(22.98±43.74)ng/L,여대조조적(4.25±5.82)ng/L비교균명현승고(P<0.05),삼조간비교차이야균유통계학의의(P<0.05),정상백단백뇨1조중응용힐사탄자혈청TGF-β1수평교미용힐사탄자명현하강[(5.77±1.90)ng/L비(8.23±8.78)ng/L](P<0.05),기여량조응용힐사탄자교미용힐사탄자혈청TGF-β1수평무명현하강.결론 혈청TGF-β1수평승고여당뇨병급조기당뇨병신병상관,조기응용힐사탄가능통과강저혈청TGF-β1적수평연완당뇨병신병적발생화발전.
Objective To investigate the relationship between serum transforming growth factor- β1(TGF- β1) levels and early diabetic nephropathy and clarify whether valsartan plays a role in renal protection by reducing the level of serum TGF-β1. Methods The study subjects were divided into four groups:control group (30 cases); normal albuminuria group 1 (NA1 group with 12 cases, U MA/Cr < 10 μg/mg combined with type 2 diabetes);normal albuminuria group 2 (NA2 group with 19 cases,UMA/Cr 10-30 μg/mg combined with type 2 diabetes); microalbuminuria group ( MA group with 35 cases, U MA/Cr 31-300 μg/mg combined with type 2 diabetes). All these type 2 diabetic patients were suffering from diabetic retinopathy, and valsartan ( 80 mg/d) were medicated for those combined with hypertension. The serum TGF-β1 levels were measured by enzyme-linked immunosorbent assay in all subjects. Results Serum TGF- β1 levels in three diabetes groups were (7.41 ± 2.68 ), ( 10.52 ± 4.10), (22.98 ± 43.74) ng/L, respectively, all of which were higher than those in control group [(4.25 ± 5.82) ng/L] (P < 0.05). There were significant differences in serum TGF- β1 levels among MA group, NA2 group and NA1 group (P < 0.05 ). Serum TGF-β1 levels in NA1 group with valsartan treatment significantly decreased compared with those without valsartan treatment (P < 0.05), whereas there was no significant reduction in NA2 and MA group with valsartan treatment (P > 0.05). Conclusions High serum TGF-β1 level may be associated with type 2 diabetes and early diabetic nephropathy. Early intervention of valsartan may be delay the onset and development of diabetic nephropathy by decreasing the serum TGF-β1 level.