| Objective: The levels of serum MMP-9(metalloproteinase matrix -9)T1MP-1 (tissue inhibitor of metalloproteinase-1) and CFV(type IV collagen) were measured by ELISA in normal controls and cases with type 2 DM including cases without albuminuria and with microalbumiuria and with macroalbuminuria based on the urinary albumin excretion rate (UAER), the levels of systolic blood pressure (SBP) diastolic blood pressure (DBF) body mass index(BMI)^ waist hip ratio (WHR), fasting blood glucose (FBG). post blood glucose (PBG) hemoglobinA 1 c (HbA 1c blood urea nitrogen (BUN) blood creatinine (Cr) uric acid (UA) et al were also measured , furthermore, compared with those parameters in above groups .we also investigated the relationship among MMP-9 TIMP-1 CIV and the possible correlation between every one of them and UAER BUN Cr UA to determine the state of those variations in diabetic nephropathy (DN) and the effect on the onset and development of DN in order to study the significance of them in the pathogenesis of DN. So that we maybe offer some new and useful method in the design of the early diagnostic and therapeutic approaches to threat and prevent the progression in DN .Methods: 69 patients with type 2 DM (1997 ADA diagnostic standards ) , 39 male and 30 female, (53.3?1.31) years old .None had present acute or chronic inflammatory disease history of liver or kidney disease N pulmonary fibrosisN or collagen disease Taken 18 normal controls, 9 male and 9 female (50.17+ 10.06)years old. DM patients were divided into three groups based on UAER measurements, including 40 cases without albuminuria (A group) 18 cases with microalbumiuria (B group) and 11 cases with macroalbuminuria (C group) .After absolute diet for 10-12 hours venous blood samples were obtained in the next day morning. We measured the levels of serum MMP T1MP-1 and CIV by ELISA and the levels of SBP, DBP BMI WHR, FBG, PBG HbAlc, BUN Cr UA et al were also measured ,meanwhile, the urine samples of 24 hours were taken for measuring albumiuria to calculate UAER. We compared those data in above groups, furthermore, to investigate the relationship among MMP-9 TIMP-1 CIV and the possible correlation between every one of them and UAER BUN Cr UA We also took the age DM duration BMI WHR SBP DBP FBG PBG HbAlc as independent variables to study the relationship or correlation with MMP-9 TIMP-1 and CIV. All these data were expressed as mean+SE, Statistical comparisons were done using independent t test or one-way analysis variance(ANOVA),correlation and univariate regression analysis were applied when appropriate .All the statistical analysis were dealt with SPSS 10.0 software. P<0.05 was considered statistical significant.Results: The levels of TIMP-1 and CIV were markedly elevated in DM group than in normal control (NC ) groups (both P0.00 1), while there was no significant difference in the level of MMP-9 between the above two groups( P=0.140). The levels of TEMP-1 and CIV in macroalbuminuria groups were significantly higher than those in microalbuminuria none-albuminuria and NC groups(all PO.001), the level of TIMP-1 in microalbuminuria was also significantly higher than those in none-albuminuria and NC groups(P<0.05, P<0.01), while the levels of MMP-9 and the ratio of MMP-9/TIMP-1 in macroalbuminuria were significantly lower than those in microalbuminuria^ none-albuminuriagroups and NC groups (all P <0.001) ,the ratio of MMP-9ATIMP-1 in microalbuminuria group was also significantly lower than those in none-albuminuria and normal control groups( P <0.01, P <0.01) .There were remarkably positive correlation between TIMP-1 and diabetic duration SBP UAER Cr; while there were significantly negative correlation between MMP-9 and diabetic duration UAER. We also found that there was a significantly positive correlation between TIMP-1 and CIV, while there were significantly negative correlation between MMP-9 and TIMP-1 CIV.Conclusion: Abnormal metabolism of collagen and close related metalloproteinases exist in type 2 diabetic patients, those results d...
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