Growth Differentation Factor-15 Leveland Its Association With Albuminuria And Diabetic Retinopathy In Patients With Type 2 Diabetes

Objective:One of the early manifestations of diabetic nephropathy is the elevated urinary albumin level. Diabetes mellitus and diabetic nephropathy belong to diabetic microangiopathydiabetic microangiopathy Diabetic microangiopathy(DMAP) is the leading factor affecting the survival rate of patients with diabetes and also the pathological basis for organ damage in diabetes complications. Genetic factors, metabolic and immune disorders, stream dynamics disorder and influences of a variety of cytokines involved in the pathogenesis of DMAP.Growth Differentiation Factor-15( GDF-15) GDF-15(also known asMIC-1) is a rmember of the TGF-β superfamily with anti-inflammatory property. For the past few years GDF-15 receives extensive attention for its anti-inflammatory, anti-tissue damage, anti-tumor and anti-proliferative characteristic, Some cardiovascular studies point towards cardioprotective property of this cytokine.To investigate GDF-15 level and its association with albuminuria and DR in type 2 diabetes mellitus(T2DM).Methods Patients with type 2 diabetes were collected from department of endocrinology, cases of the standard were selected to join this study,related clinical indicators of patients were collected. e GFR were calculated by the MDRD formula, morning urine samples was collected to measure ACR, ELISA method were used to investigate GDF-15 level and its association with albuminuria and DR in type 2 diabetes mellitus(T2DM).Results:Part 1 Growth differentiation factor-15 level and its association with albuminuria in patients with type 2 diabetes1. GDF-15 level increased in microalbuminuria group than in normal people(P<0.01); GDF-15 level increased in macroalbuminuria group than in microalbuminuria group and nomoalbuminuria group(P<0.01).2.GDF-15 level increased in mild renal dysfunction group than nonmal renal function group(P<0.01);GDF-15 level increased in chronic renal failure group than in mild renal dysfunction group and nonmal renal function group(P<0.01).3、The partial correlation analysis showed that,GDF-15 concentration was significantly and positively correlated with ACR(r=0.378, P <0.01)、s Cr(0.448, P <0.01), and GDF-15 concentration was significantly and negatively correlated with e GFR(r=-0.139, P<0.01).4.The multiple linear regression analysis showed that GDF-15 was a independent risk factor for predicting DN in type 2 diabetic patients.Part 2 Growth differentiation factor-15 level and its association withdiabetic retinopathy in patients with type 2 diabetes1.GDF-15 level increased in DR group than in NDR group(P<0.01).2.The logistic correlation analysis showed that, GDF-15 is an independent risk factor of DR(OR=1.325, P<0.05).Conclusions:1. In patients with T2 DM GDF-15 level elevated in the early stage of microalbuminuria, elevated GDF-15 are associated with the aggravation of albuminuria, as an independent contributing factor of ACR, GDF-15 is expected to become a novel biomarker to evaluate the severity of type 2diabetic nephropathy.2. The concentration of GDF-15 significant increased in patients with DR, GDF-15 is an independent risk factor of DR.