Association Between Endothelium-dependent Vasodilatation And Serum TGF-?1 In Patients With Diabetic Nephropathy

Objective:To investigate the relationship between serum TGF-?1 levels and vascular endothelial function in diabetic nephropathy patients,and to clarify if there is difference between serum TGF-?1 levels and vascular endothelial function in diabetic nephropathy patients with early stage and clinical stageMethods: Choose 82 patients with diabetes mellitus at the First Hospital of Dalian Medical University from August 2015 until January 2016.The study subjects were divided into two groups according to the microalbuminuria/creatinine ratio(UMA/Cre):12 cases are normal albuminuria group(NA group,UMA/Cre<30?g/mg)with type 2 diabetes;70 cases are diabetic nephropathy group(MA group,UMA/Cre> 30?g/mg),then the diabetic nephropathy group were divided into two groups:44cases are microalbuminuria group(MA1 group,UMA/Cre 30-300?g/mg)with diabetes,26 cases are macroalbuminuria group(MA2group,UMA/Cre >300?g/mg)with diabetes.Endothelium-dependent dilation function of brachial artery was measured by high resolving power colour doppler echography,The serum trans-forming growth factor-?1(TGF-?1)levels were measured by enzyme-linked immuno sorbent assay in all subjects.To compare the flow-mediated endothelium-dependent vasodilation(FMD)and serum TGF-?1 levels,and to clarify if there is difference between serum TGF-?1 levels and vascular endothelial function in diabetic nephropathy patients with early stage and clinical stage.To compare the biochemical immunological indices between serum TGF-?1 levels and FMD.Results:1.The differernce of waistline?BMI?FPG?DBP?FCP?TC?TG?HDL-C?LDL-C?ALT?AST?CRP?FMD in each groups had not statistically significance(P>0.05).The differernce of age ? couse of disease and Hb A1 c had statistically significance(P<0.05).2.Serum TGF-?1 levels of patients in MA1 group and MA2 group had significantly higher compared with the normal albuminuria group(P<0.05),but Serum TGF-?1 levels of patients in MA2 group was a litter higher than the patients in MA2 group,but had not statistically significance(P>0.05).3.BUN ? Cre ? Cys C were positive correlation with serum TGF-?1 levels respectively.(P<0.05),and BUN is independent influence factor of serum TGF-?1.4.FMD value has significant negative correlation with Hb A1c?age?2h CP?ALP,positive correlation with DBP(P<0.05),and age?2h CP?ALP are independent influence factors of the FMD value.5.The FMD value had not statistically significance in each group(P>0.05).6.In MA group and MA1 group,serum TGF-?1 levels and FMD value has significant negative correlation(P<0.05),but serum TGF-?1 levels and FMD value has no correlation in NA group?MA2 group.Conclusion:1.Serum TGF-?1 levels was involved in the progression of diabetic nephropathy with early stage,can be one of diagnostic indicators for early diabetic nephropathy.2.In diabetic nephropathy patients,Serum TGF-?1 levels is negatively correlated with FMD value,prompted that TGF-?1 may participate in the endothelial dysfunction of diabetic nephropathy.