Mechanisms of elevation of serum and urinary concentrations of soluble thrombomodulin in diabetic patients: Possible application as a marker for vascular endothelial injury
Mechanisms of elevation of serum and urinary concentrations of soluble thrombomodulin in diabetic patients: Possible application as a marker for vascular endothelial injury
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DOI：
10.1016/s0026-0495(98)90272-4
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发表时间：
1998-03-01
影响因子：
9.8
通讯作者：
Takemura, Y
中科院分区：
文献类型：
--
作者：
Aso, Y;Inukai, T;Takemura, Y
本文测定了71例非胰岛素依赖型糖尿病（NIDDM）患者和132例年龄匹配的对照者的血清和尿液中可溶性血栓调节蛋白（TM）水平，以阐明TM水平升高的机制。我们将TM水平与尿白蛋白排泄（UAE）、肌酐（Cr）清除率和肾小管损伤指标（如尿β 2-微球蛋白）进行比较。糖尿病患者血清TM水平明显高于对照组（P <0.001），尿TM水平也明显高于对照组（P <0.001）。糖尿病患者血清TM与血清Cr、UAE呈正相关，与Cr清除率呈负相关（P <0.001）。糖尿病患者尿TM水平与24小时葡萄糖排泄量和血清1，5-脱水葡萄糖醇（1，5-AG）水平显著相关（P <0.001）。糖尿病患者尿TM水平与肾功能无相关性。患者血清和尿液TM水平之间也无相关性。这些结果表明，虽然血清TM水平受到损害的肾清除TM的影响，这个参数可能是一个有用的标记物血管内皮损伤的糖尿病患者。另一方面，由于糖尿病患者尿中TM水平的升高阻碍了他们尿中葡萄糖的排泄，因此尿TM水平与糖尿病患者的血管内皮损伤无关。版权所有（C）1998由W.B.桑德斯公司
Serum and urinary levels of soluble thrombomodulin (TM) were measured in 71 patients with non-insulin-dependent diabetes mellitus (NIDDM) and 132 age-matched control subjects to elucidate the mechanisms involved in increased TM levels. We compared the TM level with urinary albumin excretion (UAE), creatinine (Cr) clearance, and indices of renal tubular damage such as urinary beta(2)-microglobulin. Serum TM was significantly higher in diabetic patients versus control subjects (P < .001) regardless of whether the patients had diabetic nephropathy, Urinary TM levels were also higher in diabetic patients than in control subjects (P < .001). Serum TM in diabetic patients was correlated positively with serum Cr and UAE and inversely with the Cr clearance rate (P < .001, respectively). The urinary level of TM in diabetic patients was significantly correlated with 24-hour glucose excretion and the serum level of 1,5-anhydroglucitol (1,5-AG) (P < .001). However, no correlations were found between urinary TM levels and renal function in diabetic patients. There was also no correlation between serum and urinary levels of TM in the patients. These results suggest that although the serum TM level is influenced by an impairment of the renal clearance of TM, this parameter may be a useful marker for vascular endothelial injury in diabetic patients. On the other hand, since the elevated urinary level of TM in the patients paralleled their urinary excretion of glucose, urinary TM levels do not correlate with vascular endothelial injury in diabetic patients. Copyright (C) 1998 by W.B. Saunders Company.