Study On Relationship Between AOPP, ICAM-1, IL-1β In Serum And Diabetic Nephropathy And The Intervention Of Simvastatin

Object: To study the clinical significance of serum advance oxidative protein products (AOPP), intercellular adhesion molecule1(ICAM-1), interleukin-1β(IL-1β) in patients with diabetic nephropathy(DN), and the therapeutic mechanism of Simvastatin.Methods: Eighty-nine patienents with type 2 diabetic mellitus were divided into three groups: normal albumin urine group (31 patients), microamount albumin urine group (28 patients) ,and dominancy albumin urine group (30 patients) according to their urinary albumin excretion rate (UAER),30 healthy subjects were used as controls. AOPP, ICAM-1, IL-1βwas measured by enzyme-linked- immuno sorbent assay(ELISA) method in the type 2 diabetic mellitus and the healthy persons .The patients with microamount albumin urine and dominancy albumin urine were treated with simvaststin.Results: (1) The concentration of AOPP, ICAM-1,IL-1βin the three groups with type 2 diabetic mellitus was higher than that of the thirty healthy persons(P <0.05), higher in the dominancy albumin urine group than that in the microamount albumin urine and normal albumin urine groups(p<0.01), The concentration of AOPP, ICAM-1,IL-1βin the microamount albumin urine group was higher than the normal albumin urine group(p<0.05), the concentrations of AOPP, ICAM-1 and IL-1βwas positively correlated(the concentrations of AOPP was positively correlated with ICAM-1, r=0.744, P<0.01; the concentrations of AOPP was positively correlated with IL-1β, r=0.760, P<0.01; the concentrations of ICAM-1 was positively correlated with IL-1β, r=0.711, P<0.01).Higher serum AOPP, ICAM-1 and IL-1βwas associated with higher UAER (the concentrations of AOPP was positively correlated with UAER, r=0.813, P <0.01; the concentrations of ICAM-1 was positively correlated with UAER, r=0.815, P <0.01; the concentrations of IL-1βwas positively correlated with UAER, r=0.809, P <0.01).the UAER in the normal albumin urine group and the healthy subjects was equal (p>0.05),but the concentration of AOPP, ICAM-1 and IL-1βin the normal albumin urine group was higher than the healthy subjects(P <0.05).(2) After treatment with Simvastatin for 8 weeks in patients with microamount albumin urine and dominancy albumin urine, the urine protein contents of 24h,the serum levels of AOPP, ICAM-1, IL-1βwere all decreased significantly compared with those before treatment respectively (P〈0.05). After treatment for 16 weeks the above indices remained decreased until treatment for 24 weeks(P〈0.01〉.Conclusions: (1) The plasma levels of AOPP, ICAM-1 and IL-1βwere sensitive markers for early diagnosis of DN and associated positively with the onset and progression of DM. The test of plasma levels of AOPP, ICAM-1, IL-1βand UAER were probably useful for early diagnosis of DN.(2)Simvastatin may have effect on diabetic renal microangiopathy via antioxidation and the inhibition of inflammatory reaction,and may have important meaning in early prevention from diabetic renal microangiopathy.