Association of urinary inflammatory markers and renal decline in microalbuminuric type 1 diabetics
Association of urinary inflammatory markers and renal decline in microalbuminuric type 1 diabetics
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DOI：
10.1681/asn.2007050556
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发表时间：
2008-04-01
影响因子：
13.6
通讯作者：
Krolewski, Andrzej S.
中科院分区：
文献类型：
--
作者：
Wolkow, Pawel P.;Niewczas, Monika A.;Krolewski, Andrzej S.
进行性肾功能下降开始于三分之一的微量白蛋白尿和1型糖尿病患者。这项研究检查了这种下降是否与尿液中炎症标志物的排泄增加有关。在1991年招募的1型糖尿病微量白蛋白尿自然史的第一次Joslin研究的尿样中测量了5种炎症标志物（IL-6、IL-8、单核细胞趋化蛋白-1、干扰素-γ-诱导蛋白（IP-10）和巨噬细胞炎症蛋白-1 δ）。样本来自43名微量白蛋白尿和稳定肾功能（非下降者）的参与者，来自28名微量白蛋白尿和早期进行性肾功能下降（下降者）的参与者，以及来自74名正常白蛋白尿和稳定肾功能（参考）的参与者。所有五种炎症标志物的尿浓度在下降组中显著高于非下降组，后者与参考组相似。多变量分析显示，两种以上标志物升高的患者发生早期肾功能进行性下降的可能性超过5倍。相反，C-反应蛋白、IL-8和巨噬细胞炎性蛋白-1 δ的血清浓度在下降者和非下降者之间没有差异。这些结果支持肾脏炎症过程促进1型糖尿病患者肾病进展的假设。
Progressive renal function decline begins in one third of patients with microalbuminuria and type 1 diabetes. This study examined whether this decline is associated with elevated excretion of inflammatory markers in urine. Five inflammatory markers (IL-6, IL-8, monocyte chemoattractant protein-1, interferon-gamma-inducible protein (IP-10), and macrophage inflammatory protein-1 delta) were measured in urine samples from the First Joslin Study of the Natural History of Microalbuminuria in Type 1 Diabetes, a cohort recruited in 1991. Samples were obtained from 43 participants with microalbuminuria and stable renal function (nondecliners), from 28 with microalbuminuria and early progressive renal function decline (decliners), and from 74 with normoalbuminuria and stable renal function (reference). Urinary concentrations of all five inflammatory markers were significantly higher in decliners than in nondecliners, who were similar to the reference group. Multivariate analysis revealed that those with more than two markers elevated were more than five times as likely to have early progressive decline of renal function. In contrast, serum concentrations of C-reactive protein, IL-8, and macrophage inflammatory protein-1 delta did not differ between decliners and nondecliners. These results support the hypothesis that inflammatory processes in the kidney contribute to the progression of nephropathy in patients with type 1 diabetes.