Involvement Of Apoptosis In Patients With Diabetic Nephropathy: A Study On Plasma Soluble Fas Levels

Aims We investigated the relationship between levels of plasma soluble Fas (s-Fas) and stages of diabetic nephropathy, with special reference to apoptosis and clinical features of diabetic nephropathy in the patients with diabetic nephropathy.Methods We selected the 25 patients in Ⅲ stage diabetic nephropathy( UAE20~200μg/min ) , the 25 patients in Ⅳ stage diabetic nephropathy(UAE>200μg/min),25 patients with NIDDM and 25 healthy adults .s- Fas levels in 100patients were investigated by Enzyme Linked Immunosorbent Assay (ELISA) method,the results were analyzed statistically.Results The relationship between the diabetic nephropathy and these factors suggest that there are no correlations between the s-Fas level and age and gender. Creatinine and urinary albumin levels increased with the advancement of the diabetic nephropathy. creatinine clearance decreased with the advancement of the diabetic nephropathy .There was a positive correlation between plasma s-Fas and creatinine levels (r=0.424 ,P<0.05) and between s-Fas level and urinary albumin (r=0.474 , P<0.05). There was a negative correlation between plasma s-Fas level and creatinine clearance (r= 0.374, P<0.05). Plasma s-Fas level in the healthy adults ,NIDDM , stage 1 and stage Ⅳ were 2.3±0.6 ng/ml , 2.5 ±0.5 ng/ml , 2.6±0.1 ng/ml and 5.4±0.5 ng/ml, respectively. Plasma s-Fas level of the stage Ⅳ was significantly higher than that of the stage Ⅲ (P<0.05 ),and there was no significant difference in plasma s-Fas levels between the NIDDM and the stage Ⅲ diabetic nephropathy(P>0.05), and between the NIDDM and healthy subjects(P>0.05).Conclusion Plasma s-Fas level of the stage Ⅳ was significantly higher than that of the stage Ⅲ and NIDDM. There was a positive correlation between plasma s-Fas and creatinine level, and between s-Fas level and urinary albumin. There was a negative correlation between plasma s-Fas level and creatinine clearance. These data suggest that apoptosis is involved in the advancement of diabetic nephropathy, and that plasma s-Fas level might be a predicting factor for prognosis.