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目的 探讨糖尿病大鼠血红蛋白糖基化终末产物 (Hb AGE)与肾脏改变的关系。方法采用竞争性酶联免疫吸附分析法 (ELISA)检测 44只 12周和 2 8周病程的链脲佐菌素 (STZ) 糖尿病大鼠和 14只正常对照大鼠的Hb AGE含量 ,并测定尿蛋白 /肌酐 (Pr/Cr)比值及病程 2 8周时的肾小球基底膜厚度 (GBMT)。结果 随着病程的延长 ,Hb AGE水平显著增高 (P <0 .0 1) ,与血糖和HbA1c呈显著性正相关 ,但与HbA1c的关系更密切。Hb AGE与肾小球组织AGE(GTE AGE)含量呈显著性正相关 (r=0 .6 86 2 ,P <0 .0 1) ,二者与尿Pr/Cr比值和GBMT具显著相关性 ;胰岛素和氨基胍可降低Hb AGE水平 ,减少尿蛋白 ,阻止基底膜增厚。结论 Hb AGE可作为AGE循环标志物 ,反映慢性高血糖和肾小球AGE含量 ,有助于了解糖尿病时的肾脏改变 ,其水平长期增高可能是糖尿病肾病的一个危险因素。
Objective To investigate the relationship between hemoglobin glycated end products (Hb AGE) and renal changes in diabetic rats. Methods Forty-four streptozotocin (STZ) diabetic rats and 14 normal control rats at 44 weeks of 12 weeks and 28 weeks of age were used to detect the Hb AGE levels by competitive enzyme-linked immunosorbent assay (ELISA) Protein / creatinine (Pr / Cr) ratio and duration of 28 weeks glomerular basement membrane thickness (GBMT). Results With the prolongation of the course of disease, the Hb AGE level was significantly higher (P <0.01) and positively correlated with blood glucose and HbA1c, but was more closely related to HbA1c. There was a significant positive correlation between Hb AGE and glomerular AGE (r = 0.8662, P <0.01), both of which were significantly correlated with urinary Pr / Cr ratio and GBMT. Insulin and aminoguanidine reduce Hb AGE levels, reduce urinary protein, and prevent thickening of the basement membrane. Conclusion Hb AGE can be used as a marker of AGE cycle, reflecting chronic hyperglycemia and glomerular AGE content, which helps to understand the changes of the kidneys in diabetic patients. Long-term increase of Hb AGE may be a risk factor for diabetic nephropathy.