摘要目的 探讨2型糖尿病患者血清血管生成抑制蛋白1(vasohibin-1,VASH-1)的表达及其临床意义.方法 选择辽宁省朝阳市中心医院2015年11月至2017年12月收治的2型糖尿病患者422例,根据尿白蛋白与尿肌酐的比值(urinary albumin to creatinine ratio,UACR)将患者分为正常白蛋白尿组(UACR＜30 mg/g) 149例、微量白蛋白尿组(30 mg/g≤UACR≤300 mg/g) 143例、大量白蛋白尿组(UACR＞300 mg/g) 130例.采集同期在我院健康查体者300例作为对照组.采用酶联免疫吸附法测定各组研究对象血清VASH-1、转化生长因子β1(transforming growth factor-β1,TGF-β1)浓度,并进行对比分析.结果 糖尿病组和对照组VASH-1分别为(579±236)、(350±141) ng/L,TGF-β1分别为(18.92±2.21)、(5.69±0.70)μg/L,两组比较差异均有统计学意义(t值分别为4.721、6.142,P均＜0.01).正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组患者血清VASH-1分别为(450±182)、(571±194)、(786±201) ng/L,血清TGF-β1分别为(11.71±1.81)、(14.02±2.91)、(19.32±1.97) μg/L,与正常白蛋白尿组比较,微量白蛋白尿组、大量白蛋白尿组患者血清VASH-1、TGF-β1均明显升高,差异有统计学意义(P均＜0.05);大量白蛋白尿组患者血清VASH-1、TGF-β1水平明显高于微量白蛋白尿组,两组比较差异有统计学意义(P＜0.05).多元线性回归分析结果表明,糖尿病患者血清VASH-1水平与TGF-β1呈正相关(r=0.554,P=0.000).结论 2型糖尿病患者随着DN微血管病变的进展,通过负反馈作用使得血清VASH-1浓度明显升高,以调节控制新生血管的形成,延缓肾间质纤维化,从而达到对肾脏的保护作用.

abstractsObjective To investigate the expression and clinical significance of vasohibin-1 (VASH-1) in patients with type 2 diabetes mellitus.Methods From November 2015 to December 2017,four hundred and twenty-two patients with T2DM in Chaoyang Central Hospital were selected and divided into three groups according to the urinary albumin excretion rate (UACR):normal albuminuria group (UACR ＜30 mg/g,149 cases),microalbuminuria group (30 ≤ UACR ≤ 300 mg/g,143 cases),clinical albuminuria group(UACR＞300 mg/g,130 cases).Three hundred healthy subjects in Chaoyang Central Hospital during the same period were selected as control group.The levels of serum VASH-1 and transforming growth factor-β1 (TGF-β1) in each group were determined by enzyme linked immunosorbent assay.Results VASH-1 and TGF-β1 in diabetic group and control group were (579±236) ng/L,(350±141) ng/L and (18.92 ±2.21) μg/L,(5.69 ± 0.70) μg/L,respectively.There were significant differences between the two groups (t =4.721,6.142,P＜0.01).The serum VASH-1 levels in normal albuminuria group,microalbuminuria group and massive albuminuria group were (450+182) ng/L,(571±194) ng/L,(786±201) ng/L,and the serum TGF-β1 levels were (11.71 ± 1.81) μg/L,(14.02 ± 2.91) μg/L,(19.32 ± 1.97) μg/L,respectively.Compared with the normal albuminuria group,the serum VASH-1 and TGF-β1 levels in the microalbuminuria group and the massive albuminuria group were significantly higher (P＜0.05),and the serum VASH-1 and TGF-β1 levels in the massive albuminuria group were significantly higher than those in the microalbuminuria group,with significant difference between the two groups (P＜0.05).Multivariate linear regression analysis showed that serum VASH-1 level was positively correlated with TGF-β1 in diabetic patients (r=0.554,P=0.000).Conclusion With the progress of DN microangiopathy,the serum VASH-1 concentration in type 2 diabetes mellitus increased significantly through negative feedback to regulate and control the formation of neovascularization and delay renal interstitial fibrosis,so as to achieve the protection of the kidney.