|
Objective To observe the changes of diabetic patients serum and urine concentrations of midkine (MIDKINE, MK), to explore the relationship between hematuria MK levels and diabetic nephropathy. The method selected 96 diabetic patients hospitalized in Zhejiang Hospital from July 2006 to December 2007, according to the urinary albumin excretion rate divided into three groups: normal albuminuria group (36 cases), microalbuminuria group (30 cases ), proteinuria group (30 patients), family history of diabetes, normal subjects (n = 30) as a control group. The enzyme-linked immunosorbent assay serum and urine MK level. Groups were compared MK level of serum and urine and blood triglycerides, cholesterol, high density lipoprotein, low-density lipoprotein, estimated glomerular filtration rate, fasting glucose, HbAlc, systolic blood pressure, diastolic blood pressure, body mass index other indicators of change and correlation analysis. The results compared with the control group and normal albuminuria group, serum MK massive proteinuria group was significantly higher (P <0.01). Urine MK levels in three groups of normal albuminuria group, microalbuminuria group and a large number of proteinuria upward trend, pairwise comparisons significant difference (P <0.01). No difference between the normal control group with normal albuminuria group. Analysis of covariance exclude systolic blood pressure, HbAlc, fasting glucose, high-density lipoprotein, the course of the disease and the impact of the glomerular filtration rate, there are significant differences in serum and urine MK level of proteinuria group and the control group. Urine MK levels in normal albuminuria group, microalbuminuria group and massive proteinuria group group also there are still significant differences. Correlation analysis showed that each group of diabetic patients serum MK and urine MK showed a positive correlation (r = 0.51, P <0.001), of serum MK and FPG was positively correlated (r = 0.21, P = 0.04), and glomerular filtration rate was negative correlation (r = -0.22, P = 0.03), the urinary MK and urinary albumin excretion rate (r = 0.40, P <0.001) and disease duration (r = 0.23, P = 0.04) were positively correlated. The conclusion between serum and urine MK closely related. Serum MK levels may be affected by the glomerular filtration rate and the impact of short-term fluctuations in blood glucose, urinary albumin excretion rate and duration of the impact on the level of urine MK. Serum MK level associated with massive proteinuria in patients with type 2 diabetes compared to normal healthy people increased urine MK level was progressively increased with the elevated level of proteinuria and lipids, blood glucose, blood pressure and renal function mixed factors, prompted MK may be involved in the occurrence and development of clinical diabetic nephropathy.
|