Circulating and urinary transforming growth factor β1, Amadori albumin, and complications of type 1 diabetes -: The EURODIAB Prospective Complications Study
Circulating and urinary transforming growth factor β1, Amadori albumin, and complications of type 1 diabetes -: The EURODIAB Prospective Complications Study
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DOI：
10.2337/diacare.25.12.2320
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发表时间：
2002-12-01
期刊：
影响因子：
16.2
通讯作者：
Stehouwer, CDA
中科院分区：
文献类型：
--
作者：
Chaturvedi, N;Schalkwijk, CG;Stehouwer, CDA
β-转化生长因子（TGF）-β 1在糖尿病中过度表达，这是高血糖和早期糖化终产物产生的结果，可能是与糖尿病相关的特征性肾脏结构变化的原因。我们试图研究的作用，尿液和循环TGF-β 1和其启动子Amadori白蛋白在血管并发症的1型diabetes.Research设计和方法，本文章报道了一个嵌套的病例对照研究，从EURODIAB前瞻性并发症研究欧洲人1型糖尿病。病例受试者（n=356）是所有个人与一个或多个糖尿病并发症;对照组（n=185）是所有个人没有证据的consequence.Results-Urinary TGF-β 1和Amadori白蛋白升高的患者微量或macroalbuminuria。大量白蛋白尿与正常白蛋白尿的标准化回归效应（SRE）分别为2.45（尿TGF-β 1的95% CI 1.88-3.18，P=0.0001）和1.67（Amadori白蛋白的95% CI 1.34-2.07，P=0.001）。当调整HbA 1c、Amadori白蛋白和血压后，尿TGF-β 1的大小仍具有统计学意义。与无视网膜病变的个体相比，增殖性视网膜病变个体的循环TGF-β 1升高（SRE 1.29 [1.07-1.550]，P=0.007）。在多变量模型中，这一结果减弱为1.16（0.95-1.43，P=0.2），主要是因为HbA（1c）。结论：大量白蛋白尿中尿TGF-β 1水平升高与Amadori白蛋白和HbA（1c）升高以及血压升高相关。相比之下，只有循环中的TGF-β 1与增殖性视网膜病变有关，HbA（1c）在很大程度上解释了这一点。这些发现可能为理解机制和治疗干预提供新的途径。
Objective-Transforming growth factor (TGF)-beta1 is overexpressed in diabetes as a consequence of hyperglycemia and the creation of early glycated end products and may be responsible for the characteristic structural renal changes associated with diabetes. We sought to examine the role of both urinary and circulating TGF-beta1 and its promoter Amadori albumin in the vascular complications of type 1 diabetes.Research Design and Methods-The present article reports on a nested case-control study from the EURODIAB Prospective Complications Study of Europeans with type 1 diabetes. Case subjects (n=356) were all individuals with one or more complications of diabetes; control subjects (n=185) were all individuals with no evidence of complications.Results-Urinary TGF-beta1 and Amadori albumin were elevated in patients with micro- or macroalbuminuria. Standardized regression effects (SREs) for macroalbuminuria versus normoalbuminuria were 2.45 (95% CI 1.88-3.18, P=0.0001 for urinary TGF-beta1) and 1.67 (1.34-2.07, P=0.001 for Amadori albumin). The SIZE for urinary TGF-beta1 remained statistically significant when adjusted for HbA(1c) Amadori albumin, and blood pressure. Circulating TGF-beta1 was elevated in individuals with proliferative retinopathy compared with individuals without retinopathy (SRE 1.29 [1.07-1.550], P=0.007). This result was attenuated to 1.16 (0.95-1.43, P=0.2) in the multivariate model, largely because of HbA(1c).Conclusions-Elevated levels of urinary TGF-beta1 in macroalbuminuria were associated with elevations in Amadori albumin and HbA(1c) and also in blood pressure. In contrast, only circulating TGF-beta1 was related to proliferative retinopathy, and HbA(1c) largely accounted for this. These findings may indicate novel pathways for understanding mechanisms and therapeutic interventions.