2型糖尿病患者尿液胞外囊泡中转化生长因子β1和CD2相关蛋白与糖尿病慢性肾脏疾病的相关性研究

摘要

目的：探讨尿液胞外囊泡（EVs）中转化生长因子β1（TGF‐β1）和CD2相关蛋白（CD2AP）能否作为糖尿病慢性肾脏疾病（CKD）的生物标记物。方法收集 T2DM 患者48例，其中，单纯 T2DM者18例，微量白蛋白尿者18例，大量白蛋白尿者12例。RT‐PCR检测EVs中 TGF‐β1和CD2AP的表达水平。结果 T2DM 组尿液 EVs中 TGF‐β1 mRNA 表达水平低于其他两组（P＜0.05）。CD2AP mRNA表达水平高于其他两组（P＜0.05）。TGF‐β1表达水平与UAER、Scr、及胱抑素C（Cys‐C）呈正相关（r＝0.491、0.351、0.468，P＜0.05）；CD2AP水平与 UAER及Cys‐C呈负相关（r＝－0.605、－0.385， P＜0.01）。结论尿液EVs中，TGF‐β1和CD2AP能反映CKD的进程，可作为其生物标记物。%Objective To investigate whether transforming growth factor‐β1 (TGF‐β1)and CD2‐associated protein(CD2AP) in urine extracellular vesicles (EVs) could be used as potential biomarkers of CKD. Methods A total of 48 patients with type 2 diabetes were enrolled in this study and divided into three groups :patients with normoalbuminuria(T2DM group ,n=18) ,microalbuminuria group(n=18) and macroalbuminuria group(n= 12).TGF‐β1 and CD2AP expression levels of urinary EVs were tested by real‐time PCR. Results The TGF‐β1 level of urinary EVs were significantly lower in T 2DM group than in microalbuminuria group and macroalbuminuria group(P< 0.05).The CD2AP level were significantly higher in T2DM group than in microalbuminuria group and macroalbuminuria group (P<0.01). TGF‐β1 was positively correlated with UAER(r=0.491 ,P<0.01) ,Cystatin C(r=0.468 ,P<0.01) and Scr(r=0.351 ,P< 0.05) ,whereas CD2AP was negatively correlated with UAER (r= -0.605 ,P< 0.01)and Cystatin C (r= -0.385 ,P<0.01). Conclusion These results suggest the potential use of urinary EVs TGF‐β1 and CD2AP as biomarkers of the progress of CKD.