Expression And Significance Of CD44 In Diabetic Nephropathy

Objective: To study the expression and significance of adhesion molecule glycoprotein(CD44) in patients at various stages of diabetic nephropathy(DN) , and provide useful message and method to prevent and treat the injury of diabetic nephropathy. To observe the changes of serum lipoprotein(a)[lp(a)] in patients with diabetes mellitus(DM).Methods: 60 patients with type 2 DM were divided into three groups according to their urine albumin excretion rate (UAER): DM1 : UAER <20 g/min . 20 cases. DM2: UAER20-200(jg/min , 20 cases. DM3: UAER>200ug/min, 20 cases.The expression of CD44 in peripheral blood of those patients were assessed by flow cytometry, controled with 30 cases of normal people. Fasting blood glucose(FBG), triglyceride(TG), high-density lipoprotein and lp(a) levels were also measured in all subjects, plasma HbA1c and urinary N-acetyl- -D-glucosaminidase(NAG) level was determined in all diabetic patients. Correlations between serum TG, TC, HDL, lp(a), plasma HbAic and CD44 positive cell were analysed.Results: 1. The number of CD44 positive cells in the blood of diabetics was higher than that in the control group(P<0.01), There was significant difference among the three groups, and the level in the DN group(DM2^ DM3) was significantly higher than that of non-DN group(DMI). 2. Serum lp(a) of diabetics was higher than that in the control group(P<0.01), There was significant difference among the three groups, and the level in the DN group were significantly higher than that of non-DN group. 3. Compared with the control group , urinary NAG of normal albuminuria group increased. There was no significant difference among the three groups. 4 . There was a positive correlation between expression of CD44 and serum lp(a) in patients with DM.so between CD44 and urinary NAG. However there was no relationship between CD44 and other lipid constituents, HbAic.Conclusions : 1. CD44 may participate in the acceleration and progression of diabetic nephropathy injury. The level of CD44 expression maybe regarded as a reference index, which was used to determine the degree pathological lesions in diebetic nephropathy injury. 2. lp(a) may played an important role in the diabetic nephropathy injury. There was a positive correlation beween CD44 and serum lp(a) 3. Renal tubular injury of diabetics may appeared before glomerular injury. CD44 may participate in the acceleration of renal tubular injury.