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伴有和不伴有高血压及微量白蛋白尿的非胰岛素依赖型糖尿病患者成纤维细胞的细胞内钙处理

Intracellular calcium handling by fibroblasts from non-insulin dependent diabetic patients with and without hypertension and microalbuminuria.

作者信息

Solini A, Di Virgilio F, Sfriso A, Bruseghin M, Crepaldi G, Nosadini R

机构信息

Department of Internal Medicine, University of Padova, Italy.

出版信息

Kidney Int. 1996 Aug;50(2):618-26. doi: 10.1038/ki.1996.357.

Abstract

Intracellular calcium ([(Ca2+)i]) plays a role in many cellular functions, and is involved in the pathogenesis of some conditions observed in non-insulin dependent diabetic patients (NIDDM), such as hypertension and insulin resistance. Hyperinsulinemia and hyperglycemia are also implicated in the pathogenesis of chronic diabetes complications. It is not clear whether disturbances in [(Ca2+)i] are accounted for only by metabolic abnormalities of diabetes or by other mechanisms. The aim of this study was to investigate [(Ca2+)i] handling by skin fibroblasts in NIDDM patients with similar features regarding diabetes duration and metabolic control, but who differ concerning blood pressure levels and albumin excretion rate. Using a fluorimetric technique with the indicator Fura-2/ AM, we investigated the effect of chronic exposure to insulin and glucose on [(Ca2+)i] after FGF stimulation in fibroblasts from NIDDM with hypertension alone (NIDDM H+M-) and with hypertension and microalbuminuria (NIDDM H+M+) in comparison with normotensive normoalbuminuric NIDDM (NIDDM H-M-) and control subjects (C). We studied also a group of hypertensive non-diabetic subjects (HYPER). We found that (1) FGF increases [(Ca2+)i] in all subjects; (2) insulin or high glucose per se increase [(Ca2+)i] in NIDDM H+M+ and NIDDM H+M- with respect to NIDDM H-M- and C; (3) HYPER show a [(Ca2+)i] response similar to that of NIDDM H+M- and NIDDM H+M+; (4) when stimuli are combined, all NIDDM have altered [(Ca2+)i] with respect to C, but NIDDM H+M-, NIDDM H+M+ and HYPER have higher values than NIDDM H-M-. This disorder in [(Ca2+)i] appears to be an intrinsic feature of a subgroup of hypertensive NIDDM patients, which persists in cultured cells, at least partially independent of the metabolic challenge of diabetes in vivo, and could contribute to the development of their renal and cardiovascular complications.

摘要

细胞内钙([(Ca2+)i])在许多细胞功能中发挥作用,并参与非胰岛素依赖型糖尿病患者(NIDDM)所出现的某些病症的发病机制,如高血压和胰岛素抵抗。高胰岛素血症和高血糖症也与慢性糖尿病并发症的发病机制有关。尚不清楚[(Ca2+)i]的紊乱是否仅由糖尿病的代谢异常引起,还是由其他机制导致。本研究的目的是调查病程和代谢控制情况相似,但血压水平和白蛋白排泄率不同的NIDDM患者皮肤成纤维细胞对[(Ca2+)i]的处理情况。使用荧光指示剂Fura-2/AM技术,我们研究了在单独患有高血压的NIDDM(NIDDM H+M-)、患有高血压和微量白蛋白尿的NIDDM(NIDDM H+M+)中,与血压正常且白蛋白尿正常的NIDDM(NIDDM H-M-)和对照受试者(C)相比,成纤维细胞经FGF刺激后,长期暴露于胰岛素和葡萄糖对[(Ca2+)i]的影响。我们还研究了一组高血压非糖尿病受试者(HYPER)。我们发现:(1)FGF可增加所有受试者的[(Ca2+)i];(2)与NIDDM H-M-和C相比,胰岛素或高糖本身可增加NIDDM H+M+和NIDDM H+M-的[(Ca2+)i];(3)HYPER的[(Ca2+)i]反应与NIDDM H+M-和NIDDM H+M+相似;(4)当刺激因素联合作用时,所有NIDDM患者的[(Ca2+)i]相对于C均发生改变,但NIDDM H+M-、NIDDM H+M+和HYPER的值高于NIDDM H-M-。[(Ca2+)i]的这种紊乱似乎是高血压NIDDM患者亚组的一个内在特征,在培养细胞中持续存在,至少部分独立于体内糖尿病的代谢挑战,并可能导致其肾脏和心血管并发症的发生。

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