2型糖尿病肾病患者尿基质金属蛋白酶-9(MMP-9)水平与肾损伤

Levels of urinary matrix metalloproteinase-9 (MMP-9) and renal injuries in patients with type 2 diabetic nephropathy.

作者信息

Tashiro Kyoichi, Koyanagi Ichiro, Ohara Ikko, Ito Takamichi, Saitoh Akemi, Horikoshi Satoshi, Tomino Yasuhiko

机构信息

Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan.

出版信息

J Clin Lab Anal. 2004;18(3):206-10. doi: 10.1002/jcla.20024.

Abstract

To determine correlations among the levels of urinary MMP-9 and type-IV collagen, hyperglycemia, urinary protein excretion, and renal injuries in patients with type 2 diabetic nephropathy, we measured levels of urinary MMP-9 and protein, blood urea nitrogen (BUN), serum creatinine (s-Cr), fasting plasma glucose (FPG), and glycohemoglobin A1c (HbA1c) in 47 diabetic patients and 14 healthy adults. Urinary type-IV collagen was also measured in 28 diabetic patients and seven healthy adults. Patients with diabetic nephropathy were divided into two groups: 1). patients with normoalbuminuria or microalbuminuria (0-299 mg/g.Cr; n=27), and 2). patients with macroalbuminuria (>300 mg/g.Cr; n=20). The mean level of urinary MMP-9 in group 2 was significantly higher than those in healthy adults (P<0.05), and the levels of urinary MMP-9 in patients with diabetic nephropathy increased in accordance with the clinical stage of the disease. The levels of urinary MMP-9 tended to be correlated with HbA1c in these patients, but the correlation was not statistically significant. The mean level of urinary type-IV collagen in group 2 of patients with diabetic nephropathy was significantly higher than that in group 1 and healthy adults. Levels of urinary type-IV collagen in patients with diabetic nephropathy also increased in accordance with the clinical stage of the disease. The results suggest that measurements of urinary MMP-9, as well as urinary type-IV collagen, may be useful for evaluating the degree of renal injuries in patients with type 2 diabetic nephropathy, especially in the early stage.

摘要

为了确定2型糖尿病肾病患者尿基质金属蛋白酶-9(MMP-9)和IV型胶原水平、高血糖、尿蛋白排泄及肾损伤之间的相关性,我们检测了47例糖尿病患者和14例健康成年人的尿MMP-9和蛋白水平、血尿素氮(BUN)、血清肌酐(s-Cr)、空腹血糖(FPG)及糖化血红蛋白A1c(HbA1c)。还检测了28例糖尿病患者和7例健康成年人的尿IV型胶原。糖尿病肾病患者被分为两组:1). 正常白蛋白尿或微量白蛋白尿患者(0 - 299 mg/g.Cr;n = 27),以及2). 大量白蛋白尿患者(>300 mg/g.Cr;n = 20)。第2组患者尿MMP-9的平均水平显著高于健康成年人(P<0.05),糖尿病肾病患者尿MMP-9水平随疾病临床分期增加。这些患者中尿MMP-9水平与HbA1c有相关趋势,但相关性无统计学意义。糖尿病肾病第2组患者尿IV型胶原的平均水平显著高于第1组和健康成年人。糖尿病肾病患者尿IV型胶原水平也随疾病临床分期增加。结果表明,检测尿MMP-9以及尿IV型胶原可能有助于评估2型糖尿病肾病患者的肾损伤程度,尤其是在早期。

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