Study On The Correlation Between Cd147 And The Severity Of Type 2 Diabetic Nephropathy

Diabetic nephropathy(DN)is one of the major microvascular complications of diabetes and the primary cause of end-stage renal disease(ESRD)[1].Type 2 diabetic nephropathy(T2DN)accounts for the vast majority.Due to its inconspicuous early symptoms and limited clinical treatment methods,most patients rapidly progress to Chronic renal failure(CRF),which has become a heavy social medical,economic burden.CD 147 is a glycosylated transmembrane protein with a variety of biological functions,which is involved in pathophysiological processes such as inflammation,immune response and interstitial fibrosis in kidney diseases.At present,some studies have reported that CD147 is related to the development of T2DN.Objective:To study the correlation between CD 147 and the severity of T2DN.1.To analyze the correlation between the expression of CD147 and the severity of T2DN.2.To investigate the correlation between plasma and urine concentrations of CD 147 and the severity of T2DN.Methods:Patients diagnosed with T2DN by renal biopsy at the renal hemodialysis center of Shaanxi provincial people’s hospital from July 2016 to March 2019 were collected as the experimental group,and the normal para-cancerous kidney tissues of patients with renal cell carcinoma were used as the control group.Immunohistochemical staining(IHC)method was used to stain the kidney tissue specimens of each patient with CD 147,and semi-quantitative scoring was performed according to the number of positive cells to determine the expression and localization of CD147 in T2DN kidney tissue,and analyze the correlation between the expression of CD 147 and the severity of T2DN.Patients with type 2 diabetes hospitalized in the department of endocrinology of Shaanxi provincial people’s hospital from April to September 2019 were collected as the experimental group,and healthy volunteers were the normal control group.The fasting venous blood and morning urine of the selected subjects were collected,respectively,and the plasma and urine CD 147 concentrations were detected by enzyme-linked immunoadsorption assay(ELISA).The general conditions and clinical indicators of the experimental group and control group were collected,and the correlation between the plasma and urine CD 147 concentrations and clinical indicators was analyzed.Results:1.Expression and localization of CD147 in renal tissue of patients with T2DN1.1 IHC specimens were observed under light microscopy.In the pathological control group:CD 147 was highly expressed in the lateral basement membrane of normal renal tubular epithelial cells,but not in the glomerular and vascular endothelial cell.Experimental group:in patients with T2DN,the expression of CD 147 in the sites with severe renal interstitial injury(such as renal tubular atrophy and interstitial fibrosis)was significantly decreased,and inflammatory cells infiltrated by interstitium also have CD 147 expression;In addition,CD 147 was expressed in the damaged glomerulus and blood vessels,including cellular crescent formation,globular lesions with balloon adhesion,but nodular sclerosing glomerulus does not。1.2 Rank correlation was used to analyze the correlation between CD 147 expression and clinical、histological indicators in patients with T2DN.The results showed that:in clinical indicators,CD 147 score was negatively correlated with serum creatinine(r=-0.498,P<0.05)and positively correlated with eGFR(r=0.486,P<0.05).Among the histological indicators,the expression score of CD 147 was negatively correlated with the score of interstitial injury(r=-0.628,P<0.05),and there was no statistically significant correlation with the grading of glomerular injury(r=-0.333,P>0.05).2.Correlation analysis between plasma and urine concentrations of CD147 and severity of T2DN2.1 The plasma and urine concentrations of CD147 in the experimental group were significantly different from those in the normal control group(P<0.05).There was no statistically significant difference in plasma CD147 concentration(P>0.05),and there was a statistically significant difference in urinary CD147 concentration between the clinical diabetes group and the simple diabetes group(P<0.05).2.2 Linear correlation was used to analyze the correlation between plasma CD147 concentration and clinical indicators.The results showed that:the plasma CD 147 concentration and urine CD 147 concentration in the diabetes group were positively correlated(r=0.608,P<0.05).In the early diabetic nephropathy group,plasma CD147 concentration was positively correlated respectively with 24h urine protein quantification(r=0.851,P<0.05)and urine CD147 concentration(r=0.933,P<0.05),and negatively correlated with eGFR(r=-0.713,P<0.05).In the clinical diabetic nephropathy group,the plasma CD 147 concentration was positively correlated respectively with the serum creatinine(r=0.795,P<0.05),the 24h urine protein quantification(r=0.748,P<0.05),and the urine CD147 concentration(r=0.876,P<0.05),and negatively correlated with eGFR(r=-0.703,P<0.05).2.3 Linear correlation was used to analyze the correlation between urinary CD147 concentration and clinical indicators.The results showed that the urinary CD 147 concentration in the diabetes group was positively correlated with the plasma CD 147 concentration(r=0.608,P<0.05),and negatively correlated with HbAlc(r=-0.703,P<0.05).In the early diabetic nephropathy group,urinary CD147 concentration was positively correlated respectively with plasma CD147 concentration(r=0.933,P<0.05)and 24h urine protein quantification(r=0.852,P<0.05),and negatively correlated with eGFR(r=-0.774,P<0.05).In the clinical diabetic nephropathy group,urinary CD147 concentration was positively correlated respectively with serum creatinine(r=0.797,P<0.05),plasma CD147 concentration(r=0.876,P<0.05),and 24h urine protein quantification(r=0.673,P<0.05),and negatively correlated with eGFR(r=-0.875,P<0.05).Conclusion:1.The expression of CD 147 is related to the severity of T2DN.The more severe the renal tubular interstitial injury,the less CD147 expression.Nodular sclerosing glomerulus is not expressed.2.Plasma and Urinary CD147 concentration is related to the severity of T2DN,The renal function damaged is more severe,the concentration of CD 147 in plasma and urinehigher,which can assist in the early diagnosis,assessment of the condition and prognosis of T2DN.