Wang S-T, Zhang C-Y, Zhang C-M, Rong W
Department of Endocrinology, Affiliated Yidu Central Hospital of Weifang Medical College, Weifang, China.
Exp Clin Endocrinol Diabetes. 2015 Feb;123(2):106-11. doi: 10.1055/s-0034-1390447. Epub 2014 Dec 12.
To investigate the plasma osteoprotegerin level and osteoprotegerin expression in renal biopsy tissue in type 2 diabetes with nephropathy.
Plasma osteoprotegerin level was measured by enzyme-linked immunoassay in 48 type 2 diabetes with normoalbuminuria, 48 patients with microalbuminuria, 44 patients with macroalbuminuria and 40 healthy persons. Part of diabetes patients with nephropathy were performed kidney biopsy by ultrasound guide. The osteoprotegerin expression in kidney biopsy tissue is examined by immunohistochemistry.
The plasma osteoprotegerin levels were significantly elevated in patients with microalbuminuria (3.73±0.75 ng/l) and macroalbuminuria (4.68±0.82 ng/l) as compared with patients with normoalbuminuria (2.71±0.69 ng/l) and control subjects (2.11±0.42 ng/l). And the plasma osteoprotegerin level in macroalbuminuric group was also higher than that in microalbuminuria group. The plasma osteoprotegerin level had a positive correlation with the fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), glycohemoglobinA1c (HbA1C), high sensitive C-reactive protein (hsCRP) and log(UAER). Multivariate regression analysis revealed that plasma osteoprotegerin level was an independent factor associated with albuminuria in type 2 diabetes. The immunohistochemistry results showed that positive immunostaining for osteoprotegerin was observed in the renal tubule cells of biopsy and not in glomerulus, and the osteoprotegerin expression was higher in macroalbuminuria group than that in microalbuminuria group.
The plasma osteoprotegerin level and the osteoprotegerin expression in renal tubule cells of biopsy tissue were increased in nephropathy of type 2 diabetes. This finding supports the growing concept that osteoprotegerin may act as an important regulatory molecule in the angiopathy, and particularly, that it may be involved in the occurrence and development of nephropathy in type 2 diabetes.
研究2型糖尿病肾病患者血浆骨保护素水平及肾活检组织中骨保护素的表达情况。
采用酶联免疫吸附测定法检测48例正常白蛋白尿的2型糖尿病患者、48例微量白蛋白尿患者、44例大量白蛋白尿患者及40例健康人的血浆骨保护素水平。部分糖尿病肾病患者在超声引导下行肾活检。采用免疫组织化学法检测肾活检组织中骨保护素的表达。
与正常白蛋白尿患者（2.71±0.69 ng/l）及对照组（2.11±0.42 ng/l）相比，微量白蛋白尿患者（3.73±0.75 ng/l）和大量白蛋白尿患者（4.68±0.82 ng/l）的血浆骨保护素水平显著升高。且大量白蛋白尿组的血浆骨保护素水平高于微量白蛋白尿组。血浆骨保护素水平与空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白A1c（HbA1C）、高敏C反应蛋白（hsCRP）及log（尿白蛋白排泄率）呈正相关。多因素回归分析显示，血浆骨保护素水平是2型糖尿病患者白蛋白尿的独立相关因素。免疫组织化学结果显示，肾活检肾小管细胞中可见骨保护素阳性免疫染色，肾小球中未见，且大量白蛋白尿组的骨保护素表达高于微量白蛋白尿组。
2型糖尿病肾病患者血浆骨保护素水平及肾活检组织肾小管细胞中骨保护素表达增加。这一发现支持了骨保护素可能作为血管病变中重要调节分子的观点，尤其是其可能参与2型糖尿病肾病的发生发展。
