Cherney David Z I, Xiao Fengxia, Zimpelmann Joseph, Har Ronnie L H, Lai Vesta, Scholey James W, Reich Heather N, Burns Kevin D
a Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Can J Physiol Pharmacol. 2014 Aug;92(8):703-6. doi: 10.1139/cjpp-2014-0065. Epub 2014 May 15.
Angiotensin-converting enzyme 2 (ACE2) is expressed in the kidney and may be renoprotective. We determined whether urinary ACE2 enzyme activity and protein levels (ELISA), as well as angiotensinogen and ACE, are elevated during clamped euglycemia (4-6 mmol·L(-1)) in patients with uncomplicated type 1 diabetes (T1D, n = 58) compared with normoglycemic controls (n = 21). We also measured the effect of clamped hyperglycemia (9-11 mmol·L(-1)) on each urinary factor in T1D patients. Urinary ACE2 activity and protein levels were higher during clamped euglycemia in T1D compared with the controls (p < 0.0001). In contrast, urinary angiotensinogen levels (p = 0.27) and ACE excretion (p = 0.68) did not differ. In response to clamped hyperglycemia in T1D, urinary ACE2 protein decreased (p < 0.0001), whereas urinary ACE2 activity as well as angiotensinogen and ACE levels remained unchanged. Urinary ACE2 activity and protein expression are increased in T1D patients prior to the onset of clinical complications. Further work is required to determine the functional role of urinary ACE2 in early T1D.
血管紧张素转换酶2（ACE2）在肾脏中表达，可能具有肾脏保护作用。我们比较了单纯1型糖尿病患者（T1D，n = 58）与血糖正常对照组（n = 21）在钳夹维持正常血糖（4 - 6 mmol·L⁻¹）期间尿ACE2酶活性、蛋白水平（ELISA法）以及血管紧张素原和ACE是否升高。我们还测定了钳夹维持高血糖（9 - 11 mmol·L⁻¹）对T1D患者各尿因子的影响。与对照组相比，T1D患者在钳夹维持正常血糖期间尿ACE2活性和蛋白水平更高（p < 0.0001）。相反，尿血管紧张素原水平（p = 0.27）和ACE排泄量（p = 0.68）无差异。T1D患者在钳夹维持高血糖时，尿ACE2蛋白减少（p < 0.0001），而尿ACE2活性以及血管紧张素原和ACE水平保持不变。在临床并发症出现之前，T1D患者尿ACE2活性和蛋白表达增加。需要进一步研究以确定尿ACE2在早期T1D中的功能作用。
