Inci A, Olmaz R, Sarı F, Coban M, Ellidag H Y, Sarıkaya M
Division of Nephrology, Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
Division of Nephrology, Internal Medicine, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
Hippokratia. 2016 Jul-Sep;20(3):198-203.
In the present study, we aimed to assess the relationship between the levels of soluble Klotho (s-Klotho) and oxidative stress markers in diabetic nephropathy patients with different stages of chronic kidney disease (CKD) and albuminuria levels.
We enrolled 109 patients with type 2 diabetes (mean age, 61.63 ± 9.77 years) and 32 healthy controls (mean age, 49.53 ± 7.32 years) between January and June 2014. Patients were classified into three groups based on their urinary albumin/creatinine ratio (UACR). Blood samples were collected to measure the levels of s-Klotho, serum creatinine, calcium, phosphorus, 25-hydroxyvitamin D3, and parathyroid hormone (PTH). We used the total oxidant status (TOS), total antioxidant status (TAS), ischemia-modified albumin (IMA), and ischemia-modified albumin ratio (IMAR) values to measure the oxidative status. Moreover, the oxidative stress index (OSI) was estimated as the percentage ratio of TOS/TAS values.
The TOS, TAS, and OSI values were significantly greater in the diabetic nephropathy patients compared to controls (p <0.001). When patients were classified based on their UACR, we noted that the TOS, OSI, and IMA values did not significantly differ, although the TAS (p <0.001), and IMAR (p =0.002) values significantly differed between the groups. The s-Klotho levels also significantly differed (p =0.031) between the groups. These s-Klotho levels exhibited a significant positive correlation with TOS (r =0.186, p =0.034) and OSI (r =0.207 p =0.018), but showed no correlation with the estimated glomerular filtration rate; UACR; HbA1c, calcium, phosphorus, and PTH levels; and TAS, IMA, and IMAR values.
Oxidative stress is greater in patients with diabetic nephropathy, and the TOS was positively correlated with s-Klotho levels in diabetic patients. The therapeutic reduction of oxidative stress in patients with diabetic nephropathy could improve the renal and cardiovascular outcomes. Hippokratia 2016, 20(3): 198-203.
在本研究中，我们旨在评估不同慢性肾脏病（CKD）阶段和蛋白尿水平的糖尿病肾病患者中可溶性 Klotho（s-Klotho）水平与氧化应激标志物之间的关系。
2014年1月至6月，我们纳入了109例2型糖尿病患者（平均年龄61.63±9.77岁）和32例健康对照者（平均年龄49.53±7.32岁）。根据尿白蛋白/肌酐比值（UACR）将患者分为三组。采集血样以检测s-Klotho、血清肌酐、钙、磷、25-羟基维生素D3和甲状旁腺激素（PTH）水平。我们使用总氧化状态（TOS）、总抗氧化状态（TAS）、缺血修饰白蛋白（IMA）和缺血修饰白蛋白比值（IMAR）值来测量氧化状态。此外，氧化应激指数（OSI）估计为TOS/TAS值的百分比。
与对照组相比，糖尿病肾病患者的TOS、TAS和OSI值显著更高（p<0.001）。当根据UACR对患者进行分类时，我们注意到TOS、OSI和IMA值无显著差异，尽管各组之间的TAS（p<0.001）和IMAR（p =0.002）值存在显著差异。各组之间的s-Klotho水平也存在显著差异（p =0.031）。这些s-Klotho水平与TOS（r =0.186，p =0.034）和OSI（r =0.207，p =0.018）呈显著正相关，但与估计的肾小球滤过率、UACR、糖化血红蛋白、钙、磷和PTH水平以及TAS、IMA和IMAR值无相关性。
糖尿病肾病患者的氧化应激更大，且糖尿病患者的TOS与s-Klotho水平呈正相关。降低糖尿病肾病患者的氧化应激可能改善肾脏和心血管结局。《希波克拉底》2016年，20(3): 198 - 203。
