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不同尿白蛋白肌酐比值的2型糖尿病患者血清25(OH)VD3、HIF-1α、VEGF、vWf和IGF-1水平及其相关性

Levels of Serum 25(OH)VD3, HIF-1α, VEGF, vWf, and IGF-1 and Their Correlation in Type 2 Diabetes Patients with Different Urine Albumin Creatinine Ratio.

作者信息

Shao Ying, Lv Chuan, Yuan Qin, Wang Qiuyue

机构信息

Department of Endocrinology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China.

出版信息

J Diabetes Res. 2016;2016:1925424. doi: 10.1155/2016/1925424. Epub 2016 Mar 16.

Abstract

OBJECTIVE

To investigate changes in serum 25(OH)VD3, HIF-1α, VEGF, vWf, IGF-1, and their correlation in type 2 diabetes patients at different stages of diabetic kidney disease (DKD).

METHODS

502 type 2 diabetes patients were divided into three groups: Normoalbuminuric group (201 patients), Microalbuminuric group (171 patients), and Macroalbuminuric group (130 patients). Serum 25-hydroxyvitamin D3 [25(OH)VD3] was measured by chemiluminescence. Serum hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF), von Willebrand factor (vWf), and insulin-like growth factor-1 (IGF-1) were determined by enzyme-linked immunosorbent assay. We detected the aforementioned serum factors in all cases and 224 control subjects.

RESULTS

Serum HIF-1α, VEGF, vWf, and IGF-1 in type 2 diabetes patients were significantly higher than those in the control group and increased with the increase of Ln(ACR), respectively (P < 0.001). Serum 25(OH)VD3 was significantly lower in type 2 diabetes patients and decreased with the increase of Ln(ACR) (P < 0.001). Ln(ACR) was positively correlated with duration, HbA1c, Scr, BUN, TC, LDL, TG, UA, HIF-1α, VEGF, IGF-1, vWf, and Fg and negatively correlated with 25(OH)VD3 and eGFR.

CONCLUSION

Serum HIF-1α, VEGF, vWf, and IGF-1 may be involved in DKD process through inflammation, angiogenesis, and endothelial injury. Serum 25(OH)VD3 may have protective effects on DKD partly by inhibiting inflammation, abnormal angiogenesis, and vascular endothelial dysfunction.

摘要

目的

探讨2型糖尿病患者在糖尿病肾病(DKD)不同阶段血清25(OH)VD3、HIF-1α、VEGF、vWf、IGF-1的变化及其相关性。

方法

将502例2型糖尿病患者分为三组:正常白蛋白尿组(201例)、微量白蛋白尿组(171例)和大量白蛋白尿组(130例)。采用化学发光法测定血清25-羟维生素D3[25(OH)VD3]。采用酶联免疫吸附测定法测定血清缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)、血管性血友病因子(vWf)和胰岛素样生长因子-1(IGF-1)。我们检测了所有病例及224例对照者的上述血清因子。

结果

2型糖尿病患者血清HIF-1α、VEGF、vWf和IGF-1显著高于对照组,且分别随Ln(ACR)的升高而升高(P<0.001)。2型糖尿病患者血清25(OH)VD3显著低于对照组,并随Ln(ACR)的升高而降低(P<0.001)。Ln(ACR)与病程、糖化血红蛋白、血肌酐、尿素氮、总胆固醇、低密度脂蛋白、甘油三酯、尿酸、HIF-1α、VEGF、IGF-1、vWf和纤维蛋白原呈正相关,与25(OH)VD3和估算肾小球滤过率呈负相关。

结论

血清HIF-1α、VEGF、vWf和IGF-1可能通过炎症、血管生成和内皮损伤参与DKD的发生发展过程。血清25(OH)VD3可能部分通过抑制炎症、异常血管生成和血管内皮功能障碍对DKD起到保护作用。

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