The Change And Clinical Significance Of Serum Thrombomodulin In Diabetic Nephropathy

Objective To investigate the change of serum TM in type 1 diabetis mellitus with incipent diabetic nephropathy and its clinical significance.Methods Serum TM were measured by ELISA in 60 patients withtype 1 diabetes and 20 healthy control subjects. According to UAER, Patients were divided into normoalbuminuria group(UAER<20μ g/min) and microalbumininuria group(UAER:20-200 μ g/min). FPG, PPG, HbA1c, BUN, Cr, TG, LDL-C. TC. SBP and DBP were determined simultaneously.Results (1) The serum TM level was higher in patients with type 1 diabetes mellitus with microalbuminuria than that in patents with normoalbuminuria(34.12 ±3.88ng/ml vs 18.36±3.89ng/ml, p<0.01) and that in control subjects(34.12 ± 3.88ng/ml vs 3.58±2.69ng /ml, p<0.01), the serumTM level in patients with normoalbuminuria was higher than that in control subjects(18.36 ± 3.89ng/ml vs 3.58±2.69ng/ml, p<0.01) 。 (2) The TM level in type 1 diabetes was positively related to duration, SBP and UAER. Duration(r=0.778,p<0.001);SBP (r=0.521,p<0.001);UAER (r=0.893,p<0.001) .(3) By stepwise regression analysis, UAER, duration and LDL-C were contributors to serumTM in type 1 diabetes. UAER(Beta:0.535;P<0.001). duration (Beta:0.396;P<0.001). LDL-C (Beta:0.132;P<0.05)o Conclusions (1)In type 1 diabetets with microalbuminuria had an elevated serum TM level;Patients with normoalbuminuria had an elevated serum TM level to that in control subjects too.(2)UAER. duration and LDL-C were contributors to serum TM in type 1 diabetes.(3)The measurement of serum TM is useful in evaluating the early diagnosis and severity in type 1 diabetic nephropathy.