Uzun Sami, Ozari Muge, Gursu Meltem, Karadag Serhat, Behlul Ahmet, Sari Soner, Koldas Macit, Demir Secil, Karaali Zeynep, Ozturk Savas
a Department of Nephrology , Haseki Training and Research Hospital , Istanbul , Turkey ;
b Department of Internal Medicine , Haseki Training and Research Hospital , Istanbul , Turkey ;
Ren Fail. 2016 Sep;38(8):1193-8. doi: 10.1080/0886022X.2016.1209031. Epub 2016 Jul 19.
Immunological and inflammatory mechanisms have been shown to have role in both the development and progression of diabetic nephropathy (DNP). There is need for more specific markers for inflammation as the ones commonly used are influenced by many factors. Pentraxin-3 (PTX-3) seems to be a potential candidate. We aimed in our study to evaluate the changes of PTX-3 levels in different stages of DNP and its relationship with other inflammatory markers.
This is a cross sectional study in which patients with DNP at different stages were involved. Patient were divided into three groups according to estimated glomerular filtration rate (eGFR), microalbuminuria and proteinuria levels: Group-1: eGFR >60 mL/min and microalbuminuria, Group-2: eGFR >60 mL/min and macroalbuminuria, Group-3: eGFR <60 mL/min and macroalbuminuria. Besides the routine biochemical parameters, levels of PTX-3, high sensitivity C-reactive protein (hsCRP), interleukin (IL)-1 and tumor necrosis factor (TNF)-α was measured. Groups were compared with each other regarding the study parameters and correlation of PTX-3 with other markers was evaluated.
The mean PTX-3 level in Group-2 (0.94 ± 0.26 ng/mL) and -3 (1.35 ± 1.55 ng/mL) were higher than in Group-1 (0.81 ± 0.25 ng/mL) (p = 0.009 and p = 0.012). There was a significant correlation of PTX-3 with proteinuria (r = 0.266, p = 0.016), microalbuminuria (r = 0.304, p = 0.014) and hypoalbuminemia (r = 0.197, p = 0.043). PTX-3 was not correlated with other markers of inflammation (IL-1, TNF-α and hsCRP) and diabetic metabolic parameters (hbA1c, C-peptide, insulin and HOMA-IR). PTX-3, IL-1 and TNF-α levels increased with the advancing stage of DNP while hsCRP level did not change.
PTX-3 that increases similar to other markers of inflammation (IL-1, TNF-α) is a better inflammatory marker than hsCRP. Furthermore, there is a relationship between PTX-3 and proteinuria independent from eGFR.
免疫和炎症机制已被证明在糖尿病肾病（DNP）的发生和发展中起作用。由于常用的炎症标志物受多种因素影响，因此需要更具特异性的标志物。五聚体-3（PTX-3）似乎是一个潜在的候选者。我们在研究中旨在评估DNP不同阶段PTX-3水平的变化及其与其他炎症标志物的关系。
这是一项横断面研究，纳入了不同阶段的DNP患者。根据估计肾小球滤过率（eGFR）、微量白蛋白尿和蛋白尿水平将患者分为三组：第1组：eGFR>60 mL/min且有微量白蛋白尿；第2组：eGFR>60 mL/min且有大量白蛋白尿；第3组：eGFR<60 mL/min且有大量白蛋白尿。除常规生化参数外，还测量了PTX-3、高敏C反应蛋白（hsCRP）、白细胞介素（IL）-1和肿瘤坏死因子（TNF）-α的水平。比较各组的研究参数，并评估PTX-3与其他标志物的相关性。
第2组（0.94±0.26 ng/mL）和第3组（1.35±1.55 ng/mL）的PTX-3平均水平高于第1组（0.81±0.25 ng/mL）（p=0.009和p=0.012）。PTX-3与蛋白尿（r=0.266，p=0.016）、微量白蛋白尿（r=0.304，p=0.014）和低白蛋白血症（r=0.197，p=0.043）显著相关。PTX-3与其他炎症标志物（IL-1、TNF-α和hsCRP）以及糖尿病代谢参数（糖化血红蛋白、C肽胰岛素和稳态模型评估胰岛素抵抗指数）无关。随着DNP阶段的进展，PTX-3、IL-1和TNF-α水平升高，而hsCRP水平未改变。
与其他炎症标志物（IL-1、TNF-α）类似升高的PTX-3是比hsCRP更好的炎症标志物。此外，PTX-3与蛋白尿之间存在独立于eGFR的关系。
