| Objective:Diabetic nephropathy is one common and specific diabetic microvascular complication, and also the major cause of disability and mortality for diabetics. Transforming growth factor-β1 (TGF-β1) is a unique cytokine which induced fibrosis. Renal expression of TGF-β1 is especially abundance and its overexpression promotes cell proliferation and hypertr-ophy of renal tissue to stimulate extracellular matrix deposition. Therefore, TGF-β1 plays an important role in pathogenesis of DN. The renal protection of Valsartan which is an angiotensinⅡ(AngⅡ) receptor antagonist (ARB), has been confirmed. At present, there is no enough research about the relationship between the level of serum TGF-β1 and early DN, especially the period before microalbuminuria, as well as the effect of Valsartan on this phase of DN. Therefore, the study was to analyze the serum TGF-β1 levels of patients with early DN, in order to find out the relationship between serum TGF-β1 and early DN, and also to clarify whether Valsartan play a role in renal protection by reducing the level of serum TGF-β1.Methods:The present study included 69 patients who were suffering from type 2 diabetes and with no clinical evidence of vascular complication of the heart,brain and other chronic renal disease. All patients with high blood pressure were, medicated oral Valsartan 80mg/d for 2 weeks.69 patients were divided into normal albuminuria 0 group (NAO group) (n=5), without DR, urine microalbuminuria/creatinine (UMA/Cre)<10μg/mg, without valsartan; normal albuminuria 1 group (NA1 group) (n=12), with DR, UMA/Cre<10μg/mg, of which 4 cases with Valsartan,8 cases without Valsartan; normal albuminuria 2 group (NA2 Group) (n=17), with DR, UMA/Cre 10～30μg/mg, of which 7 with Valsartan,10 without Valsartan; microalbuminuria group(MA group)(n=35), with DR, UMA/Cre 30～300μg/mg, of which 22 with Valsartan,13 without Valsartan. The serum TGF-β1, blood creatinine (Cre), blood urea nitrogen(Urea), blood uric acid(UA), total cholesterol (TC), triglyceride(TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), glycosylated haemogloin Ale (HbA1c), fasting C peptide (FCP), postprandial 2 hour Cpeptide (2hCP) were analyzed in all subjects.Results:1.The difference of sex, duration, BMI, HbA1c, FPG, FCP,2hCP, TG, HDL-C, LDL-C, Urea, UA in four groups had not statistically significance (P>0.05). The difference of blood pressure, TC, blood Cre, urine MA/Cre had statistically significance (P<0.05, P<0.01). Compared with NAO group, NA1 group and NA2 group, blood pressure, BMI, FPG, HbA1c significantly increased in MA group.2.Serum TGF-β1 levels of NAO group, NA1 group, NA2 group and MA group were 7.33±1.16ng/L,7.41±2.68ng/L,8.52±4.10 ng/L,43.74±22.98 ng/L respectively, and compared with NA1 group, NA2 group serum TGF-β1 were significantly higher (P<0.05) in MA group; serum TGF-β1 was higher in NA2 group than in NA1 group (P<0.05), while serum TGF-β1 was higher in NA1 group than in NA0 group(P<0.05).3.Serum TGF-β1 level (5.77±1.90ng/L) was significantly decreased in NA1 group with Valsartan than those without Valsartan (8.23±2.78ng/L)(P <0.05); But in NA2 and MA group, the serum TGF-β1 levels has not been decreased by Valsartan. The serum TGF-β1 in NA2 group with Valsartan (9.56±5.06ng/L) were slightly higher than that without Valsartan (7.59±2.98ng/L), but without statistical significance (P> 0.05), whereas serum TGF-β1 in MA Group with Valsartan (54.48±29.04ng/L) were higher than that without Valsartan (12.73±6.87 ng/L).4.Serum TGF-β1 levels were not related to age, sex, duration, blood pressure, BMI, HbAlc, FPG, FCP,2hCP, TG, HDL-C, LDL-C, Urea, UA, TC and blood Cre.5.Taking urine MA/Cre level as a dependent variable, age, duration, blood pressure, BMI, HbA1c, FPG, FCP,2hCP, TG, HDL-C, LDL-C, Urea, UA, TC, Cre as the independent variables, we did the Spearman correlation analysis showed that blood pressure, BMI, FPG, TGF-β1 and DN were significantly correlated (P<0.05, P<0.01).Conclusion:1.Serum TGF-β1 level has a positive relativity with the amout of albuminuria in early diabetic nephropathy.2.Serum TGF-β1 can be one of diagnostic indicators for early diabetic nephropathy.3.Valsartan may reduce the level of renal TGF-β1 to delay the occurrence development of DN.4.Hypertension, BMI, HbA1c and TGF-β1 are important risk factors of diabetic nephropathy.
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