Laboratory and Vascular Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Thromb Res. 2010 Jun;125(6):e310-6. doi: 10.1016/j.thromres.2010.02.013. Epub 2010 Mar 21.
Deficiency of Von Willebrand factor (VWF)-cleaving protease (ADAMTS13) causes platelet thrombosis in the microcirculation. Intrarenal coagulation is thought to be associated with the development and progression of diabetic nephropathy. Our aim was to clarify the association between plasma ADAMTS13 antigen (ADAMTS13Ag) levels and diabetic nephropathy.
We measured the plasma levels of VWF antigen (VWFAg) and ADAMTS13Ag, and calculated the VWF/ADAMTS13 ratio in 86 type 2 diabetic patients and 26 healthy volunteers, to investigate the relationship between these levels and renal function. With regard to diabetic macroangiopathy, the relationship between these levels and carotid intima-media thickness (IMT) was also investigated.
A significant positive and negative correlation was noted between ADAMTS13Ag and the estimated glomerular filtration rate (eGFR), vWF/ADAMTS13 ratio and eGFR, respectively. The diabetic patients were divided into normoalbuminuria (n=50), microalbuminuria (n=8) and overt nephropathy (n=28) groups. Compared among these three groups and the 26 healthy volunteers, ADAMTS13Ag was significantly lower only in the overt nephropathy group. The mean carotid IMT was measured in 69 patients and was significantly negatively correlated with ADAMTS13Ag and positively correlated with VWF/ADAMTS13 ratio. When these 69 patients were divided into four groups according to eGFR and ADAMTS13 levels (ADAMTS13/eGFR; low/low: n=12; high/low: n=7; low/high: n=25; high/high: n=25), the mean carotid IMT was increased in patients with a low ADAMTS13Ag in the same eGFR group. The present study suggests that reduced ADAMTS13 might be associated with diabetic nephropathy.
血管性血友病因子（VWF）裂解蛋白酶（ADAMTS13）缺乏会导致微循环中的血小板血栓形成。人们认为肾内凝血与糖尿病肾病的发生和发展有关。我们的目的是阐明血浆 ADAMTS13 抗原（ADAMTS13Ag）水平与糖尿病肾病之间的关系。
我们测量了 86 例 2 型糖尿病患者和 26 名健康志愿者的血浆 VWF 抗原（VWFAg）和 ADAMTS13Ag 水平，并计算了 VWF/ADAMTS13 比值，以研究这些水平与肾功能之间的关系。关于糖尿病大血管病变，还研究了这些水平与颈动脉内膜中层厚度（IMT）之间的关系。
ADAMTS13Ag 与估计肾小球滤过率（eGFR）呈显著正相关，VWF/ADAMTS13 比值与 eGFR 呈显著负相关。将糖尿病患者分为正常白蛋白尿组（n=50）、微量白蛋白尿组（n=8）和显性肾病组（n=28）。与这三组和 26 名健康志愿者相比，仅显性肾病组 ADAMTS13Ag 显著降低。在 69 例患者中测量了平均颈动脉 IMT，发现其与 ADAMTS13Ag 呈显著负相关，与 VWF/ADAMTS13 比值呈显著正相关。根据 eGFR 和 ADAMTS13 水平（ADAMTS13/eGFR；低/低：n=12；高/低：n=7；低/高：n=25；高/高：n=25）将这 69 例患者分为四组，发现相同 eGFR 组中 ADAMTS13Ag 较低的患者，平均颈动脉 IMT 增加。本研究表明，ADAMTS13 减少可能与糖尿病肾病有关。
