Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Diabetes Metab Res Rev. 2018 Nov;34(8):e3057. doi: 10.1002/dmrr.3057. Epub 2018 Sep 27.
The aim of the study was to evaluate the relationship between serum cathelicidin level and diabetic nephropathy (DN) in patients with type 1 diabetes mellitus (T1DM).
The study group consisted of 76 patients with T1DM (47 men), aged 36 ± 7 years, and with duration of T1DM 14 (7-18) years. Serum cathelicidin was measured by ELISA test in healthy controls (n = 20) and in 76 T1DM patients grouped as follows: G1 = patients with normal urinary albumin excretion (n = 20), G2 = patients with microalbumin excretion (n = 19), G3 = patients with macroalbumin excretion but normal serum creatinine level (n = 19), and G4 = patients with macroalbumin excretion with increased serum creatinine (n = 18).
There was no significant difference in serum cathelicidin levels between healthy controls and G1 diabetic patients, but serum levels were progressively increased from the stage of microalbuminuria to frank nephropathy (P < .001). Positive correlation between serum cathelicidin level and the presence of DN, thyroid-stimulating hormone, total cholesterol, and negative with male sex and fasting plasma glucose, was found. In multiple regression analysis, serum cathelicidin level was associated with the presence of DN after adjustment of sex, waist-to-hip ratio, total cholesterol, and thyroid-stimulating hormone.
Patients with T1DM and DN are characterized by increased serum cathelicidin level. There was an independent relationship between serum cathelicidin level and DN. Serum cathelicidin level can be used as an early marker for the presence and progression of DN in T1DM patients.
本研究旨在评估 1 型糖尿病(T1DM)患者血清抗菌肽水平与糖尿病肾病(DN)的关系。
研究组纳入 76 例 T1DM 患者(男 47 例,年龄 36±7 岁,T1DM 病程 14(7-18)年),健康对照组(n=20)及 T1DM 患者分为以下 4 组:G1 组:尿白蛋白正常排泄(n=20);G2 组:微量白蛋白尿排泄(n=19);G3 组:白蛋白排泄量增加但血清肌酐水平正常(n=19);G4 组:白蛋白排泄量增加伴血清肌酐升高(n=18)。采用 ELISA 法检测血清抗菌肽水平。
健康对照组与 G1 组患者血清抗菌肽水平无显著差异,但从中度白蛋白尿期至显性肾病期,血清水平逐渐升高(P<.001)。血清抗菌肽水平与 DN、促甲状腺激素、总胆固醇呈正相关,与性别、空腹血糖呈负相关。多元回归分析显示,校正性别、腰臀比、总胆固醇、促甲状腺激素后,血清抗菌肽水平与 DN 相关。
T1DM 合并 DN 患者血清抗菌肽水平升高,且血清抗菌肽水平与 DN 独立相关。血清抗菌肽水平可作为 T1DM 患者 DN 存在和进展的早期标志物。