Diabetic nephropathy is associated with low-grade inflammation in Type 1 diabetic patients
Diabetic nephropathy is associated with low-grade inflammation in Type 1 diabetic patients
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DOI：
10.1007/s00125-003-1194-5
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发表时间：
2003-10-01
期刊：
影响因子：
8.2
通讯作者：
Groop, PH
中科院分区：
文献类型：
--
作者：
Saraheimo, M;Teppo, AM;Groop, PH
目的/假设。在2型糖尿病中观察到C反应蛋白和白细胞介素-6浓度升高，这一发现提示存在炎症。在这些患者中，C-反应蛋白是糖尿病肾病的预测指标。关于1型糖尿病患者低度炎症标志物和肾病的研究显示了相互矛盾的结果。因此，我们研究了1型糖尿病患者的轻度炎症是否与糖尿病肾病相关。我们将194例1型糖尿病患者根据其白蛋白排泄率分为三组，来自芬兰糖尿病肾病研究。正常白蛋白尿的患者（n=67）没有抗高血压药物或心血管疾病的迹象，而微量白蛋白尿（n=64）或大量白蛋白尿（n=63）的患者都用血管紧张素转换酶抑制剂治疗，这种药物可以减轻低度炎症。作为胰岛素敏感性的测量，我们使用估计的葡萄糖处置率。C反应蛋白采用放射免疫法测定，白细胞介素6采用高灵敏度酶免疫法测定。微量白蛋白尿和大量白蛋白尿患者的C反应蛋白水平高于正常白蛋白尿患者（正常白蛋白尿2.0 ± 1.7，微量白蛋白尿2.6 ± 1.7，大量白蛋白尿2.9 ± 2.5 mg/l;而白细胞介素-6的升高与肾脏疾病的严重程度平行（1.9+/-1.5，2.9 +/-3.3，3.6 +/-3.1 ng/l; p
Aims/hypothesis. Increased concentrations of C-reactive protein and interleukin-6, a finding suggestive of the presence of inflammation, have been observed in Type 2 diabetes. In such patients, C-reactive protein was predictive of diabetic nephropathy. Studies on low-grade inflammatory markers and nephropathy in Type 1 diabetic patients have shown conflicting results. Therefore we studied whether low-grade inflammation is associated with diabetic nephropathy in Type 1 diabetic patients.Methods. We divided 194 Type 1 diabetic patients into three groups from the Finnish Diabetic Nephropathy Study based upon their albumin excretion rate. Patients with normoalbuminuria (n=67) had no antihypertensive medication or signs of cardiovascular disease, while patients with microalbuminuria (n=64) or macroalbuminuria (n=63) were all treated with an angiotensin-converting enzyme inhibitor, a drug that could attenuate low-grade inflammation. As a measure of insulin sensitivity we used estimated glucose disposal rate. C-reactive protein was measured by radioimmunoassay and interleukin-6 by high sensitivity enzyme immunoassay.Results. C-reactive protein was higher in micro- and macroalbuminuric patients compared to normoalbuminuric patients (normoalbuminuria 2.0+/-1.7, microalbuminuria 2.6+/-1.7, macroalbuminuria 2.9+/-2.5 mg/l; p=0.016), while interleukin-6 increased in parallel with the severity of the renal disease (1.9+/-1.5, 2.9+/-3.3, 3.6+/-3.1 ng/l; p