| ObjectiveTo observe the changes of serum midkine and urine midkine concentrations in Type 2 diabetic patients and to explore the relation between serum or urine midkine and diabetic nephropathy.MethodsNinety-six patients diagnosed with Type 2 diabetes mellitus were selected and divided into three groups according to the urinary albumin excretion rate:the normalalbuminuria group(n=36),the microalbuminuria group(n=30)and the macroalbuminuria group(n=30).The control group consisted of thirty subjects without family history of diabetes mellitus.Serum midkine and urine midkine were measured by ELISA.The changes of serum and urine midkine levels,the triglyceride level,the cholesterol level,the high-density lipoprotein level,the lower-density lipoprotein level,the fasting blood glucose level,evaluative glomerular filtration rate,HbA1c,the blood pressure and the body mass index were compared among the groups. ResultsThe serum midkine level of the macroalbuminuria group was significantly higher than that of the normalalbuminuria group and the control groups(P＜0.01). As the urine albumin excretion rate increased,so did the urine midkine level (P＜0.01).After controlling for the relevant covariates such as blood presssure, HbA1c,fasting blood glucose,high-density lipoprotein,diabetic duration and glomerular filtration rate,the serum and urine midkine levels of the macroalbuminuria group remained increasing compared with the control group. Besides,there was a significant difference in the urine midkine level between the microalbuminuria group and the macroalbuminuria group.The correlation analysis showed that there was a positive correlation between the serum midkine level and the urine midkine level in diabetic patients(r=0.51,P＜0.001).Furthermore,the serum midkine level was correlated with the fasting blood glucose level(r=0.21, P=0.04)and glomerular filtration rate(r=-0.22,P=0.03),the urine midkine level was positively correlated with urinary albumin excretion rate(r=0.40,P＜0.001)and diabetic duration(r=0.23,P=0.04).ConclusionsThere is a close relation between serum midkine and urine midkine.The serum midkine level is influenced by glomerular filtration rate and short term changes of fasting plasma glucose level,The urine midkine level is influenced by urinary albumin excretion rate and diabetic duration.The serum midkine level had a close relation with renal function.There was a progressive and graded relationship between the urine midkine level and the urine albumin excretion rate in type 2 diabetic patients,indicating that midkine may play a role in the pathogenesis and development of diabetic nephropathy. |
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