ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2015-5-61-72ssmu-189Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL PAPERSХАРАКТЕРИСТИКА СЕРДЕЧНОЙ ФОРМЫ БЕЛКА, СВЯЗЫВАЮЩЕГО ЖИРНЫЕ КИСЛОТЫ, ИНТЕРЛЕЙКИНОВ-6 И -8 КАК АЛЬТЕРНАТИВНЫХ МАРКЕРОВ ПРОГРЕССИРОВАНИЯ ДИАБЕТИЧЕСКОЙ НЕФРОПАТИИ У ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 1-го ТИПАСHARACTERISTICS OF THE HEART FATTY ACID-BINDING PROTEIN, INTERLEUKIN-6 AND INTERLEUKIN-8 AS ALTERNATIVE MARKERS OF DIABETIC NEPHROPATHY PROGRESSION IN PATIENTS WITH TYPE 1 DIABETES MELLITUSРыжиковаЮ. А.RyzhikovaYu. A.

Рыжикова Юлия Александровна – аспирант кафедры эндокринологии и диабетологии

Ryzhikova Yuliya A.

kabirova.y86@mail.ruВорожцоваИ. Н.VorozhtsovaI. N.

Ворожцова Ирина Николаевна – доктор медицинских наук, профессор, зав. кафедрой эндокринологии и диабетологии

Vorozhtsova Irina N.

kabirova.y86@mail.ruСапринаТ. В.SaprinaT. V.

Саприна Татьяна Владимировна – доктор медицинских наук, доцент кафедры эндокринологии и диабетологии

Saprina Tatiana V.

kabirova.y86@mail.ruЗавадовскаяВ. Д.ZavadovskayaV. D.

Завадовская Вера Дмитриевна – доктор медицинских наук, профессор, зав. кафедрой лучевой диагностики и лучевой терапии

Zavadovskaya Vera D.

kabirova.y86@mail.ruМериновА. Б.MerinovA. B.

Меринов Антон Борисович – врач-рентгенолог отделения рентгеновских и томографических методов диагностики

Merinov Anton B.

kabirova.y86@mail.ruКулагинаИ. В.KulaginaI. V.

Кулагина Ирина Владимировна – кандидат медицинских наук, зав. клинико-диагностической лабораторией

Kulagina Irina V.

kabirova.y86@mail.ruСибирский государственный медицинский университет, ТомскРоссияSiberian State Medical University, TomskRussian FederationНИИ кардиологии, ТомскРоссияResearch Institute for Cardiology, TomskRussian Federation2015281020151456172Copyright © Рыжикова Ю.А., Ворожцова И.Н., Саприна Т.В., Завадовская В.Д., Меринов А.Б., Кулагина И.В., 20152015Рыжикова Ю.А., Ворожцова И.Н., Саприна Т.В., Завадовская В.Д., Меринов А.Б., Кулагина И.В.Ryzhikova Y.A., Vorozhtsova I.N., Saprina T.V., Zavadovskaya V.D., Merinov A.B., Kulagina I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/189

Цель исследования – изучить альтернативные маркеры прогрессирования диабетической нефропатии (ДН), такие как сердечная форма белка, связывающего жирные кислоты (сБСЖК), интерлейкина-6 (ИЛ-6) и интерлейкина-8 (ИЛ-8) у больных сахарным диабетом 1-го типа (СД-1).

Материал и методы

Материал и методы. Обследовано 87 пациентов с СД-1 в возрасте от 18 до 54 лет (основная группа), из которых у 30 больных выявлена нормоальбуминурия (НАУ), у 29 – микроальбуминурия (МАУ) и у 28 – протеинурия (ПУ). Контрольную группу составили 24 условно здоровых донора в возрасте от 22 до 29 лет. В группу сравнения вошли 22 пациента в возрасте от 20 до 42 лет с верифицированным диагнозом эссенциальной артериальной гипертензии (АГ) без нарушений углеводного обмена. Определение суточной экскреции альбумина с мочой осуществлялось иммунотурбидиметрическим методом. Скорость клубочковой фильтрации рассчитывалась по формуле Hoek с применением сывороточной концентрации цистатина С. Содержание сБСЖК, ИЛ-6, цистатина С в сыворотке крови, а также сБСЖК, ИЛ-8 в моче определяли методом иммуноферментного анализа.

Результаты

Результаты. Анализ содержания сБСЖК в сыворотке крови показал, что концентрация данного маркера у лиц основной группы с СД-1 была выше, чем у пациентов групп контроля и сравнения. При исследовании содержания сБСЖК в моче было зарегистрировано увеличение уровня данного аналита у лиц с эссенциальной АГ и максимально высокие показатели сБСЖК у пациентов с СД-1. Концентрация ИЛ-6 как у больных с СД-1, так и у лиц с эссенциальной АГ была статистически значимо выше контрольных значений. Cодержание сБСЖК и ИЛ-6 в сыворотке, а также сБСЖК и ИЛ-8 в моче увеличивалось по мере прогрессирования ДН и было максимальным у лиц подгруппы ПУ. При этом уровень сБСЖК и ИЛ-8 в моче у пациентов подгруппы МАУ был выше по сравнению со значениями данных аналитов у лиц НАУ. Обращает на себя внимание и факт увеличенного содержания сБСЖК в моче у пациентов подгруппы НАУ по сравнению с контрольными значениями. Показатели мочевой экскреции сБСЖК и ИЛ-8 у лиц с МАУ с хронической болезнью почек (ХБП) 2-й стадии были выше по сравнению со значениями данного маркера у пациентов с МАУ с ХБП 1-й стадии.

Заключение

Заключение. Таким образом, полученные в ходе проведенного исследования результаты свидетельствуют о том, что с БСЖК и ИЛ-8 можно рассматривать в качестве альтернативных маркеров прогрессирования ДН у пациентов, страдающих СД-1.

The aim of this work was to study the levels of the heart fatty acid-binding protein (h-FABP), interleukin6 (IL-6) and interleukin-8 (IL-8), in diabetic nephropathy (DN) in patients with type 1 diabetes mellitus (T1DM). Material and methods. We examined 87 patients aged 18 to 54 with T1DM within the study group. 30 patients with type 1 diabetes were diagnosed with normoalbuminuria, 29 patients – with microalbuminuria and 28 patients – with proteinuria. The control group consisted of 24 healthy donor aged 22 to 29. The comparison group included 22 patients aged 20 to 42 with verified diagnosis of essential arterial hypertension (AH) without carbohydrate metabolism disorders. The daily urinary albumin excretion was determined by immunoturbidimetric technique. 30 patients with type 1 diabetes were diagnosed with normoalbuminuria, 29 patients – with microalbuminuria and 28 patients with proteinuria.Calculation of glomerular filtration rate was performed according to the Hoek formula with the use of cystatinС serum concentrations. Contents of h-FABP, IL-6 and cystatin C in serum and h-FABP, IL-8 inurine were determined by enzyme-linked immunosorbent assay. Results. Analysis of the h-FABP content in serum showed that the concentration of this marker in individuals with T1DM was higher than in patients of the control group and the comparison group. Analysis of the h-FABP content in the urine revealed that individuals with essential hypertension showed an increased level of h-FABP while patients with T1DM demonstrated the highest concentration of h-FABP. The concentration of IL-6 inindividuals with T1DM and in individuals with AH significantly exceeded the control values. The contents of h-FABP and IL-6 inserum and h-FABP and IL-8 inurine increased with the progression of DN and reached maximum in individuals of the proteinuria subgroup. At the same time, the levels of h-FABP and IL-8 inthe urine of patients in the microalbuminuria (MAU) subgroup were higher compared to those in individuals of the normoalbuminuria (NAU) subgroup. Noteworthy is the fact that the h-FABP content in the urine of individuals in NAU subgroup was higher compared to the control group. Furthermore, higher rates of h-FABP and IL-8 urinary excretions were observed in individuals with CKD stage 2 as compared to individuals with CKD stage1 inthe MAU subgroup. Conclusion. Thus, the results obtained in the course of the study indicate that h-FABP and IL-8 can be considered as alternative markers of DN progression in patients with T1DM. 

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The authors declare that there are no conflicts of interest present.