摘要目的：研究不同尿白蛋白排泄率(urinary albumin to creatinineratio, UACR)的2型糖尿病(T2DM)患者血清血管生成抑制蛋白1(vasohibin-1,VASH-1)的表达水平,探讨其与 T2DM 微血管并发症糖尿病肾病(Diabetic nephropathy,DN)炎症反应及纤维化的相关关系。方法选择 T2DM 患者486例,分为正常白蛋白尿组(134例,UACR<30 mg/ g)、微量白蛋白尿组(122例,UACR 30~300 mg/ g)、大量白蛋白尿组(106例,UACR>300 mg/ g)和大量白蛋白尿高血压组(124例,UACR>300 mg/ g,且患有高血压),并设正常对照组(130例),询问年龄、病程,分别测定各项生化指标以及血清 VASH-1、炎症指标(CRP、ESR)和纤维化指标(TGF-β1)的水平。结果正常白蛋白尿组、微量白蛋白尿组、大量白蛋白尿组及大量白蛋白尿高血压组的 UACR、HbA1C、ESR、CRP、TGF-β1和 VASH-1的水平显著高于正常对照组(P<0.05)；T2DM 患者血清 VASH-1水平与 UACR、HbA1C、ESR、CRP 和 TGF-β1水平呈显著正相关( r =0.521、0.261、0.519、0.523、0.479, P<0.001),血清 UACR、HbA1C、ESR、CRP 和 TGF-β1的水平是影响血清 VASH-1水平的重要因素。结论血清 VASH-1的水平可能成为早期预测 T2DM 患者 DN 的新标志物,VASH-1为糖尿病肾脏损伤的炎症反应及纤维化过程提供了新的思路和方向。

abstractsObjective To investigate the expression levels of serum vasohibin-1(VASH-1)in type 2 diabetes mellitus(T2DM)patients at different stages of urinary albumin to creatinineratio(UACR)and to attempt to investigate the relationship between VASH-1 and inflammation and fibrosis in the pathogenesis of diabetic nephropathy(DN), one of the microvascular complications of T2DM. Methods 486 patients with T2DMwere divided into four groups:normal albuminuria [ UACR<30 mg/ g, n = 134], microalbuminuria [ UACR at 30-300 mg/ g, n = 122], clinical albuminuria [UACR > 300 mg/ g, n = 106 ], and clinical albuminuria hypertensive [ UACR > 300 mg/ g, with hypertension, n=124] groups. Age, course, serum levels ofVASH1, inflammation markers(CRP, ESR)and fibrosis marker( TGF-β1) with other biochemical indicators were measured, and 130 normal control subjects were also included. Results Compared with normal control group, the levels of UACR, HbA1C ,ESR, CRP, TGF-β1 and VASH-1 in groups ofnormal albuminuria, microalbuminuria, clinical albuminuria, and clinical albuminuria hypertensive were significantly higher(P<0. 05). Pearson correlation analysis showed that levels of VASH-1 were positively correlated with UACR, HbA1C ,ESR, CRPand TGF-β1( r = 0. 521, 0. 261, 0. 519, 0. 523, 0. 479, P<0. 001), while multivariate regression analysis showed that levels of UACR, HbA1C ,ESR, CRP and TGF-β1 were important factors affecting serum VASH-1 levels. Conclusion Serum levels of VASH-1 may become new biomarkers of early diagnosis of DN. Consequently, VASH-1 level may provide a new pattern and direction of inflammation and fibrosis for consideration in diabetic kidney damage.