Correlation Study Between Calcitonin Gene-Related Peptide And Diabetic Nephropathy

Objective Capital century,the incidence of diabetes all over the world has increased by near 3 percent annual rate.As one of the main chronic complicatio- ns of diabetes,diabetic nephropathy(DN) is one of the main causes of diabetic patients disabled and death,and about 30%～40% of patients has progressed to end-stage renal disease each year.Therefore,preventing the occurrence and development of diabetic nephropathy is currently very much a topic of concern.Its pathogenesis has not yet been fully clarified,at present,it is considered to be the result of a combination of renal hemodynamics and non-hemodynamic.In recent years,the vasoactive peptides on renal hemodynam- ics has been of concern to people.So far,calcitonin gene-related peptide (CGRP) has been the strongest endogenous vasodilator peptide discovered,and widely distributes in central and peripheral nervous system and certain organs and tissues,with the strongest non-adrenergic,non-cholinergic vasodilation effect,and jointly mediates of renal vascular resistance and renal blood flow by interacting of a variety of vasoactive substances in vivo,involved in renal hemodynamic changes of diabetes,and plays an important role in the occurrence and development of diabetic nephropathy.In this paper,diabetic patients are grouped into 3 groups by detecting urinary albumin excretion rate (UAER),meanwhile, by investigating the serum concentration of calcitonin gene-related peptide (CGRP) at different stages of diabetic nephropathy,comparativing analysis of each group serum CGRP levels,and researching the relationship between CGRP and UAER, study the change and the role of CGRP in the the occurrence and development of diabetic nephropathy,in order for an in-depth to explore the pathogenesis of diabetic nephropathy,in order to provide some new ideas for the prevention and treatment of diabetic nephropathy.Methods Select hospital patients with type 2 diabetes 85 cases and 30 cases of healthy control group in this study. First, measure the UAER level of all selected objects,and according to UAER(μg/min),diabetes will be divided into three groups:30 cases with normal albuminuria group (NA group,UAER<20),30 cases with microalbuminuria group (MA group, 20≤UAER≤200),25 cases with macroalbuminuria group (CP group,UAER>200).Using enzyme-linked immun- osorbent assay the test object is measured in serum CGRP levels,simultaneous, glucose,insulin,lipids,renal levels are detected. Using analysis of variance and q test to compare the group differences in levels of CGRP, when variance uneven using rank sum test. Pearson correlation analysis the relationship between CGRP and various clinical indicators,multiple linear stepwise regression analysis the influencing factors of diabetic nephropathy.Results The serum level of CGRP decreased significantly in patients with type 2 diabetes than that in the control group (P<0.01),and the CGRP levels in NA,MA,CP group decreased gradually with the development of disease,the differences were statistically significant(P<0.01).Pearson correlation analysis showed:CGRP and course of the disease,systolic blood pressure,fasting blood glueose,triglyceride,totaleholesterol,low density lipoprotein cholesterol, urea nitrogen,creatinine,glycosylatedhemoglobin,urinary albumin excretion rate are negative correlation.With UAER as the dependent variable, other parame- ters as variables in multiple linear stepwise regression analysis,the results of the variables into the equation are asystolic blood pressure,fasting blood glueose, pasting 2 hour blood glueose,urea nitrogen,CGRP.Conclusions 1.With the progression of diabetic nephropathy,the content of CGRP in serum gradually decreased. 2. With the elevating of UAER,CGRP gradually reduced. 3. As a vasodilator in vivo the strongest peptide material, CGRP may be involved in the development of diabetic nephropathy and plays an important role in its occurrence and development process. 4. CGRP is the major factors of diabetic nephropathy.