Department of Experimental Physiology, Medical School, National and Kapodistrian University of Athens, Greece.
Clin Chem Lab Med. 2012 Jan;50(1):167-74. doi: 10.1515/cclm.2011.881.
The aim of the present study was to evaluate the role of extracellular matrix-associated glycosaminoglycans (GAGs), connective tissue growth factor (CTGF), angiogenic vascular endothelial growth factor (VEGF) and inflammatory factors (MCP-1, CD40, IFN-γ) in the development of diabetic nephropathy in type 1 diabetes (T1DM).
Plasma and urine samples from 30 T1DM patients and 20 healthy controls were used to measure the levels of CTGF, VEGF, MCP-1, CD40 and IFN-γ by ELISA. Plasma and urine GAGs were measured using a spectrophotometric method.
Plasma levels of GAGs, CD40 and MCP-1 and urine levels of GAGs and CTGF were significantly elevated in normoalbuminuric T1DM patients. A tendency to higher plasma VEGF levels was found in patients compared to controls. The urine/plasma GAGs ratio of T1DM patients was almost similar to that of healthy subjects (HS), whereas the urine/plasma CTGF ratio was about three times greater in diabetic patients compared to HS.
Conclusively, increased GAGs and CTGF excretion are evident in T1DM normoalbuminuric juveniles, possibly reflecting early renal injury signs, before the initiation of albuminuria.
本研究旨在评估细胞外基质相关糖胺聚糖(GAGs)、结缔组织生长因子(CTGF)、血管生成血管内皮生长因子(VEGF)和炎症因子(MCP-1、CD40、IFN-γ)在 1 型糖尿病(T1DM)糖尿病肾病发展中的作用。
采用酶联免疫吸附法(ELISA)检测 30 例 T1DM 患者和 20 例健康对照者的 CTGF、VEGF、MCP-1、CD40 和 IFN-γ水平。采用分光光度法测定血浆和尿液 GAGs 水平。
在正常白蛋白尿的 T1DM 患者中,血浆 GAGs、CD40 和 MCP-1 水平以及尿液 GAGs 和 CTGF 水平显著升高。与对照组相比,患者的血浆 VEGF 水平呈升高趋势。T1DM 患者的尿/血浆 GAGs 比值与健康受试者(HS)相似,而糖尿病患者的尿/血浆 CTGF 比值约为 HS 的 3 倍。
综上所述,在 T1DM 正常白蛋白尿青少年中,GAGs 和 CTGF 的排泄增加,可能反映了白蛋白尿发生前的早期肾脏损伤迹象。