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[细胞因子在糖尿病肾病进展的非侵入性诊断中的作用]

[Cytokines in noninvasive diagnostics of diabetic nephropathy progression].

作者信息

Senatorski Grzegorz, Paczek Leszek, Kropiewnicka Eugenia, Bartłomiejczyk Irena

机构信息

Klinika Immunologii, Transplantologii i Chorób Wewnetrznych Instytutu Transplantologii Akademii Medycznej w Warszawie.

出版信息

Pol Merkur Lekarski. 2002 Nov;13 Suppl 1:28-32.

Abstract

Diabetic nephropathy is major long-term complication of diabetes mellitus a social and civilization-related disease. At present, the most sensitive and non-invasive indicator of the progression of diabetic nephropathy is microalbuminuria. Morphological features such as accumulation of extracellular matrix proteins, thickening of glomerules' basement membranes are prior to microalbuminuria. The aim of our clinical study was to establish whether urine and serum TGF-beta 1 and IL-6 levels may be significant in prognosing and evaluating a risk for developing diabetic nephropathy. The trial was carried out in 68 patients with type II diabetes mellitus and a group of 10 healthy subjects served as control. Urine and serum TGF-beta 1 concentrations were evaluated, as well as, basic laboratory parameters. After one-year-observation serum creatinine level and microalbuminuria value were investigated in 60 patients with type II diabetes mellitus. In patients with type II diabetes mellitus both urine and serum TGF-beta 1 and IL-6 were elevated. After one-year-observation of patients with type II diabetes mellitus it was established that the increase of serum creatinine concentrations values were higher in those patients, whose initial TGF-beta 1 levels exceeded normal values. A positive correlation between urine TGF-beta 1 level and the progression of renal failure measured by the increase of serum creatinine level was observed. In conclusion, our findings indicate that urine TGF-beta 1 and IL-6 levels may be a good prognostic factor of the development of diabetic nephropathy in the course of diabetes mellitus.

摘要

糖尿病肾病是糖尿病的主要长期并发症,糖尿病是一种与社会和文明相关的疾病。目前,糖尿病肾病进展最敏感且无创的指标是微量白蛋白尿。细胞外基质蛋白积聚、肾小球基底膜增厚等形态学特征先于微量白蛋白尿出现。我们临床研究的目的是确定尿液和血清转化生长因子β1(TGF-β1)及白细胞介素-6(IL-6)水平在预测和评估糖尿病肾病发生风险方面是否具有重要意义。该试验对68例2型糖尿病患者进行,一组10名健康受试者作为对照。评估了尿液和血清TGF-β1浓度以及基本实验室参数。对60例2型糖尿病患者进行一年观察后,调查了血清肌酐水平和微量白蛋白尿值。2型糖尿病患者的尿液和血清TGF-β1及IL-6均升高。对2型糖尿病患者进行一年观察后发现,初始TGF-β1水平超过正常值的患者血清肌酐浓度增加值更高。观察到尿液TGF-β1水平与以血清肌酐水平升高衡量的肾衰竭进展呈正相关。总之,我们的研究结果表明,尿液TGF-β1和IL-6水平可能是糖尿病病程中糖尿病肾病发生的良好预后因素。

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