Sokolovska Jelizaveta, Stefanovics Juris, Gersone Gita, Pahirko Leonora, Valeinis Janis, Kalva-Vaivode Sanita, Rovite Vita, Blumfelds Leons, Pirags Valdis, Tretjakovs Peteris
Faculty of Medicine, University of Latvia, Riga, Latvia.
Faculty of Medicine, Department of Human Physiology and Biochemistry, Riga Stradins University, Latvia.
Exp Clin Endocrinol Diabetes. 2020 Oct;128(10):654-662. doi: 10.1055/a-1079-4711. Epub 2020 Jan 20.
Serum angiopoietin 2 levels have been associated with endothelial dysfunction and diabetic kidney disease. Derangements in autonomous nervous system lead to increased production of vasoconstrictory and angiogenic mediators such as norepinephrine and neuropeptide Y and are associated with increased risk of microvascular complications.
To investigate associations between angiopoietin 2, neuropeptide Y and diabetic kidney disease in patients with type 1 diabetes mellitus.
289 patients with type 1 diabetes mellitus duration > 1 year were included. Patients were stratified according to presence of diabetic nephropathy (macroalbuminuria, estimated glomerular filtration rate<60 ml/min/1.73 m or end-stage renal disease). Angiopoietin 2 was measured by Luminex technology. Neuropeptide Y was measured by ELISA.
Patients with diabetic nephropathy had significantly increased levels of angiopoietin 2 (4020.5 (2172.4-5778.1) pg/ml 2001.0 (1326.7-2862.7) pg/ml) and neuropeptide Y (18.22 (14.85-21.85) ng/ml 12.91 (9.96-17.07) ng/ml). Higher levels of angiopoietin 2 and neuropeptide Y were observed also in patients with arterial hypertension. Angiopoietin 2 and neuropeptide Y correlated significantly (ρ=0.245, p<0.001). Both biomarkers were significant predictors of estimated glomerular filtration rate and diabetic nephropathy in univariate regression models. In the fully adjusted regression models and after application of a stepwise selection regression method, angiopoietin 2 demonstrated a stronger predictive power for diabetic nephropathy compared to neuropeptide Y.
Diabetic nephropathy is associated with increased serum concentrations of angiopoietin 2 (marker of endothelial dysfunction) and neuropeptide Y (marker of sympathetic activity) in type 1 diabetes. Angiopoietin 2 is a more potent predictor of diabetic nephropathy compared to neuropeptide Y.
血清血管生成素2水平与内皮功能障碍及糖尿病肾病相关。自主神经系统紊乱会导致去甲肾上腺素和神经肽Y等血管收缩和血管生成介质的产生增加，并与微血管并发症风险增加相关。
探讨1型糖尿病患者血管生成素2、神经肽Y与糖尿病肾病之间的关联。
纳入289例病程超过1年的1型糖尿病患者。根据是否存在糖尿病肾病（大量蛋白尿、估计肾小球滤过率<60 ml/min/1.73 m²或终末期肾病）对患者进行分层。采用Luminex技术检测血管生成素2。采用酶联免疫吸附测定法检测神经肽Y。
糖尿病肾病患者的血管生成素2水平（4020.5（2172.4 - 5778.1）pg/ml对2001.0（1326.7 - 2862.7）pg/ml）和神经肽Y水平（18.22（14.85 - 21.85）ng/ml对12.91（9.96 - 17.07）ng/ml）显著升高。动脉高血压患者中也观察到较高水平的血管生成素2和神经肽Y。血管生成素2与神经肽Y显著相关（ρ = 0.245，p < 0.001）。在单变量回归模型中，这两种生物标志物都是估计肾小球滤过率和糖尿病肾病的显著预测指标。在完全调整的回归模型中，应用逐步选择回归方法后，与神经肽Y相比，血管生成素2对糖尿病肾病显示出更强的预测能力。
1型糖尿病患者的糖尿病肾病与血清中血管生成素2（内皮功能障碍标志物）和神经肽Y（交感神经活动标志物）浓度升高相关。与神经肽Y相比，血管生成素2是糖尿病肾病更有效的预测指标。
