首页|糖尿病肾脏病肾精亏虚证中尿ERdj3和Nephrin表达研究

糖尿病肾脏病肾精亏虚证中尿ERdj3和Nephrin表达研究

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目的 探究糖尿病肾脏病(DKD)患者肾小球足细胞是否存在内质网应激,分析患者尿液中内质网定位Dna J家族成员3(ERdj3)和足细胞保护标志蛋白(Nephrin)与中医证型、蛋白尿和肾功能的相关性.方法 以2020 年9 月—2023 年6 月北京中医药大学东直门医院东城区、通州院区诊治且基线匹配的56 例2 型糖尿病(T2DM组)和45 例糖尿病肾脏病(DKD组)患者为研究对象,其中DKD组患者再分为DKD肾精亏虚组和DKD非肾精亏虚组.比较T2DM组和DKD组、DKD非肾精亏虚组和DKD肾精亏虚组间ERdj3、Nephrin水平;分析DKD组患者ERdj3、Nephrin水平与中医肾精亏虚证积分、兼夹实证证素积分、24h尿蛋白定量、血肌酐(SCr)、估算肾小球滤过率(eGFR)的相关性.结果 DKD组患者尿ERdj3、Nephrin水平均明显高于T2DM组(P均<0.05);DKD肾精亏虚组患者尿ERdj3、Nephrin水平均明显高于DKD非肾精亏虚组(P 均<0.05).尿ERdj3 水平与DKD精亏证、气滞证、血瘀证、痰浊证积分和 24h尿蛋白定量均呈正相关(P 均<0.05),尿Nephrin水平与DKD精亏证、水湿证、血瘀证积分和24h尿蛋白定量均呈正相关(P均<0.05).结论 DKD患者存在尿ERdj3、Nephrin高表达,且二者表达水平均与精亏证积分呈正相关,有望为寻找DKD肾精亏虚证及相关兼夹实证可能的分子标记物提供客观依据.
Expression of urine ERdj3 and Nephrin in diabetes kidney disease with kidney essence deficiency syndrome
Objective It is to explore whether endoplasmic reticulum stress exists in glomerulus podocytes of patients with diabetes kidney disease(DKD),and to analyze the correlations of urinary ER-localized DnaJ family member 3(ERdj3)and Nephrin with traditional Chinese medicine syndrome types,proteinuria,and renal function.Methods Fifty-six patients with type 2 diabetes mellitus(T2DM group)and 45 patients with diabetic kidney disease(DKD group)who were diagnosed and treated in Dongcheng Branch and Tongzhou Branch of Dongzhimen Hospital of Beijing University of Chi-nese Medicine and matched at baseline from September 2020 to June 2023 were used as the study subjects,in which the patients in the DKD group were subdivided into DKD with kidney essence deficiency syndrome group and DKD without kid-ney essence deficiency syndrome group.The levels of ERdj3 and Nephrin levels were compared between T2DM group and DKD group,and between DKD with kidney essence deficiency syndrome group and DKD without kidney essence deficiency syndrome group;the correlations of the levels of ERdj3 and Nephrin with the scores of kidney essence deficiency syndrome,scores of complicating excess syndrome,24 h urine protein quantification,blood creatinine(SCr),estimated glomerular filtration rate(eGFR)were analyzed in the patients of DKD group.Results The levels of urinary ERdj3 and Nephrin in the patients of the DKD group were significantly higher than those in the T2DM group(all P<0.05),and the levels of urinary ERdj3 and Nephrin in the patients of the DKD with kidney essence deficiency syndrome group were significantly higher than those in the DKD without kidney essence deficiency syndrome group(all P<0.05).The level of urinary ERdj3 was posi-tively correlated with the scores of DKD with kidney essence deficiency syndrome,Qi stagnation syndrome,blood stasis syndrome,phlegm-turbidity syndrome and 24 h urine protein quantification(all P<0.05),and the level of urinary Neph-rin was positively correlated with the scores of DKD essence deficiency syndrome,water dampness syndrome,blood stasis syndrome and 24 h urine protein quantification(all P<0.05).Conclusion Urinary ERdj3 and Nephrin are highly ex-pressed in the patients with DKD,and their expressions are positively correlated with essence deficiency syndrome.They are expected to provide objective evidence for DKD kidney essence deficiency syndrome and related excess syndromes.

diabetes kidney diseasekidney essence deficiency syndromeendoplasmic reticulum stressER-localized DnaJ family member 3Nephrin

周盈、史扬、谢惠迪、郑毅成、高飞、王健、张先慧、柳红芳

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北京市普仁医院,北京 100062

北京中医药大学东直门医院,北京 100700

解放军总医院第一医学中心肾脏病全国重点实验室,北京 100853

北京市朝阳区中医医院,北京 100020

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糖尿病肾脏病 肾精亏虚证 内质网应激 内质网定位Dna J家族成员3 足细胞保护标志蛋白

国家自然科学基金青年科学基金项目北京中医药大学东直门医院2022年度科技创新专项

8200151229DZMKJCX-2022-003

2024

10.3969/j.issn.1008-8849.2024.16.004

现代中西医结合杂志
中国中西医结合学会河北分会,中华中医药学会

现代中西医结合杂志

CSTPCD
影响因子：1.775
ISSN：1008-8849
年,卷(期)：2024.33(16)