Grzeszczak W, Zukowska-Szczechowska E
Katedry i Kliniki Chorób Wewnetrznych i Diabetologii, Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 1998;51 Suppl 2:11-23.
Poor metabolic control, hemodynamic factors and long duration of diabetes may predispose to the development of diabetic nephropathy. Recently the hypothesis that genetic factors may play certain role in the pathogenesis of diabetic nephropathy has been also proposed. The angiotensin I converting enzyme (ACE) gene has been the main candidate gene predisposing to the development of diabetic nephropathy. One of its polymorphisms--insertion/deletion seems to be particularly associated with long-term diabetic complications. There are many candidate genes taking probable part in the pathogenesis of diabetic nephropathy. Among them we must think about: the HLA system genes, cations transporters genes, renin-angiotensin system genes, insulin sensibility dependent genes, genes coding basement membrane, genes taking part in apoprotein synthesis regulation. If there would be strong evidence that genetic factors play certain role in the pathogenesis and progression of diabetic nephropathy, the high risk diabetics could be selected and the adequate prevention could be applied.
代谢控制不佳、血流动力学因素以及糖尿病病程较长可能易引发糖尿病肾病。最近,也有人提出遗传因素可能在糖尿病肾病的发病机制中起一定作用这一假说。血管紧张素I转换酶(ACE)基因一直是易引发糖尿病肾病的主要候选基因。其多态性之一——插入/缺失似乎与糖尿病长期并发症尤其相关。有许多候选基因可能参与了糖尿病肾病的发病机制。其中我们必须考虑:HLA系统基因、阳离子转运体基因、肾素-血管紧张素系统基因、胰岛素敏感性相关基因、编码基底膜的基因、参与载脂蛋白合成调节的基因。如果有强有力的证据表明遗传因素在糖尿病肾病的发病机制及进展中起一定作用,那么就可以筛选出高危糖尿病患者并采取适当的预防措施。