| Part I Study on the Association between Vitamin D Receptor Gene Fokl (T/C) Polymorphism and Susceptibility of Type 2 Diabetic Nephropathy in Yunnan Han PopulationObjective Diabetic nephropathy is chronic pathology progress of microvascular under the influence of genetic and environmental factors, single nucleotide polymorphism (SNP) of vitamin D receptor gene (FokI) is susceptibility related to it, we aim to investigate the distribution of vitamin D receptor FokI gene polymorphism in Yunnan Han population,and to explore the relationship between SNP of fokI and type 2 diabetic nephropathy. Methods we included 276 individuals of han population of Yunan in this study:91 type 2 diabetes patients without kidney disease(DM group), their duration of diabete is more than 10 years,89 type 2 diabetic nephropathy patients (DN) group,their duration of diabete was less than 10 years and 96 healthy controls (NC group), compared the concentration of 25 hydroxy vitamin D in different groups,and using taqman probe to detect the genotype and allele of FokI,then to analysed the relationship between the polymorphisms of FokI and the susceptibility of diabetic nephropathy. Results 1.NC group had a significantly higher plasma concentrations of 25 (OH) D than DN group and DM group(P=0.00,0.00); 2. The correlation between 25 (OH) D and age,BMI,HbA1c,TG is negative(r=-0.25,-0.24,-0.35,-0.29,P<0.001);3. genotype of FokI was no different in DM group and DN group,same as in DM group and NC group;FF genotype in DN group was relatively lower than NC group(χ2=3.45, P=0.045),and there was no difference in Ff and ff genotype (P>0.05);In DN group,f allele was 53.4%,higher than DM group (RR=1.46 P<0.05);(4) Logistic regression analysis showed that ff genotype is the susceptible factor for DN (P=0.04, OR=2.37). Conclusion FokI Ff genotype accounted for a larger proportion of the the han population in Yunnan,and ff genotype was a susceptible factor for DN in Han population in Yunnan..Part Ⅱ The Value of Plasma Cys C,Hcy,sIC AM-1 for the Detection of Early-stage Diabetic NephropathyObjective Observe the change of homocysteine (Hcy),cystatin (Cys C) and soluble intercellular adhesion molecule-1 (sICAM-1) level in patients with type 2 diabetic nephropathy,to explore the significance of biochemical indicator detection for early diabetic nephropathy. Methods 180 cases of type 2 diabetes were divided into NDN and DN group according to ACR,90 cases of normal people is the control group,detected the level of Hey, CysC, sICAM-1 in three groups, and observe the relationship with UACR, and do ROC curve, the calculate its positive rate and specificity.Results (1) In group DN, Hey, CysC, sICAM-1 and UACR levels were higher than NC group and NDN group (P<0.01), Hey and CysC levels in NDN group are higher than NC group (P<0.05), and sICAM-1 had no statistical difference between the two groups (P>0.05); (2)In DN group, the positive rate of Hcy,CysC, sICAM-1 was 81.11%,56.7%,10%,specificity was 47.7%,77.8%,97.7%38.89%, 97.7%, the combining positivity was 88.8%, the area under the ROC curve of each index were 0.74,0.78,0.72 (P<0.05); (3) Hcy,CysC, sICAM-1 was positively correlated with UAER (r= 0.45,0.65,0.32,P<0.05).Conclusion (1) Hcy,CysC levels may have been abnormally increased in early stage of diabetic nephropathy,sICAM-1 may be related to the progression of diabetic nephropathy,and Hcy,CysC,sICAM-1 was positively correlated with UAER,(2) Compared with single detectionjoint detection can improve the detection rate of early-stage in diabetic nephropathy.
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