| Objetive: Diabetic nephropathy (DN) is a common and serious chronic complication of diabetic mellitus (DM) and become one of disease which can cause death. Kindey hypertrophy and glomerular hyperflitration in diabetic mellitus are considered to be early symptoms of developing diabetic nephropathy. Serveal experimental studies have showed that IGF-1 play a important role in those two symptoms. The exact mechanism of it is not clear. The most of result come from model and cell culture of type 1 diabetes. But there is few report about the relationship between IGF-1 and DN in type 2 diabetes. In recent years IGF-1,IGFBP-3 is thought to be an important factor in type 2 DM and DN.IGF-1 is similar to insulin in structure. It play important role in cell cycle progression,cell poliferation,cell differentiation,cell functions and so on.IGFBP-3 is the main storge and carrier protein of IGF-1.On this basis we investigated the serum IGF-1,IGFBP-3 in type 2 DM patients complicated and uncomplicated by DN and healthy subjects to explore the role of them in the development of the disease.Methods: Sixty-one patients with type 2 DM wereselected for the study (1999 WHO diagnostic stands). 33 male and 28 female. 55.92±11.40 years old. None have present and chronic inflammatory disease, history of liver or kidney disease. Diabetic individuals were divided into three main groups according to UAER:(1) those without DN (NA Group) (UAER<20 ug/min) (n=20). (2) early stage of diabetic nephropathy group (MA Group) (UAER 20-200 ug/min) (n=20).(3) late stage of diabetic nephropathy group(ODN Group) (UAER>200 ug/min) (n=20).Healthy individuals matching sex and age of the patients were used to as controls(n=19).The main clinical features such as FBG,PBG,HbA1C,serum lipid,renal function,BP,BMI and WHR as well were tested in all subjects. The serum levels of IGF-1 and IGFBP-3 were measured by ELISA method. All these data were expressed as mean±SE. Statistical comparisons were done using independent t test or one-way analysis variance (ANOVA) were applied when appropriate. All the statistical analysis were dealt with SPSS10.0 soft ware.Results: 1. Serum levels of IGF-1 in type 2 diabetic patients were 193.44±50.13ng/ml. Serum levels of IGF-1 in control group were 217.76±32.76ng/ml.Serum levels of IGF-1 in type 2 diabetic patients were significantly lower than that in control group (P<0.05). Serum levels of IGFBP-3 in type 2 diabetic patients were 38.38±19.92ng/ml. Serum levels of IGFBP-3 in control group were 40.47±16.29ng/ml.Serum levels of IGFBP-3 in type 2 diabetic patients were lower than that in control group, but the decrease is not significant in statistic (P>0.05).2.IGF-1 correlated negatively with FBG(r=-0.310,p<0.05).IGF-1 correlated negatively with HbA1C (r=-0.347,p<0.05).IGFBP-3 correlated negatively with HbA1C(r=-0.307.p<0.05) IGF-1 correlated positively with IGFBP-3 (r=0.478,p<0.05).3. Serum levels of IGF-1 and IGFBP-3 in the NA group were 166.63±38.69ng/ml and 26.20±9.20ng/ml. Serum levels of IGF-1 and IGFBP-3 in the MA group were 193.33±57.51ng/ml and 38.38±10.64ng/ml. Serum levels of IGF-1 and IGFBP-3 in the ODN group were 221.50±29.95ng/ml and 50.55±27.16ng/ml. Excluding the change of age,sex,FBG,PBG and HbA1C, we found serum levels of IGF-1 and IGFBP-3 in the DM patients with early stage of DN(MA) were significantly higher than those without DN(NA)(p<0.05).Serum levels of IGF-1 and IGFBP-3 in late stage of DN (ODN) were much high than in MA group (p<0.05).There was a positive correlation between serum level of IGF-1 and UAER (r=0.414,p<0.01).There was a direct correlation between serum levels of IGFBP-3 and UAER(r=0.434,p<0.01).4.There is not significant for IGF-1 and IGFBP-3 in statistic between each DN group with hypertention and without(P>0.05). Conclusion: 1.Serum levels of IGF-1 decrease in type 2diabetic patients and IGF-1correlated negatively FBG and HbA1C.These changes maybe due to elevated levels of patients blood glucose. The correlation between IGF-1...
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