Explore The Relationship Between Transforming Growth Factor Beta1and Type2Diabetic Peripheral Neuropathy

Objective:Transforming growth factor beta1（TGF-β1）has been recognized as a corefactor of diabetic nephropathy, but in recent years, the relationship between TGF-β1anddiabetic peripheral neuropathy （DPN） receiving increasing attention. The aim of this studyis to investigate the interrelationships between serum level of TGF-β1and type2diabeticperipheral neuropathy。 And the interrelationships between serum level of reducedglutathione （GSH）、peripheral blood NF-kappa B activity and serum level of TGF-β1werealso observed. In addition, looking for risk factors which may promote T2DM happenperipheral neuropathy is also one of the purposes of this study.Methods: Screening105in-ward patients with T2DM hospitalized in department ofendocrinology of second artillery force general hospital from February2012to October2012. The diagnosis of T2DM accorded with the new diagnosis criteria of WHO in1999.According to the Toronto clinical scoring system （TCSS） for the diagnosis of DPNand the classification of severity,85patients with type2diabetes are divided into fourgroups.There are20patients （A Group） without DPN （0-5points）. There are22patients（B₁group） with mild degree of DPN （6-8points）. There are22patients （B₂group） withmoderate degree of DPN （9-11points）.There are21patients （B₃group） with severedegree of DPN （12-19points）.Normal control（N group） has38people. Each group interms of gender and age match on heterogeneous. All the subject detected height, weight,blood pressure, glycated hemoglobin, blood biochemical indexes, and calculate BMI. Andall subjects determined the serum TGF-β1, GSH level and peripheral blood NF-kappa Bactivity, analyzed the change,and studied the association among the serum TGF-β1、GSHlevel,peripheral blood NF-kappaB activity and type2diabetic peripheral neuropathy.Results:1.The results of general clinical data comparison between N group and T2DM group（including group A and group B） show that there were no significant difference in age、 BMI、TC、LDL-C and Cr（p>0.05）,but there had significant difference in SBP、DBP、TG、BUN（P<0.05）.There had no difference among A group and B1、B2、B3groups in age、BMI、TC、TG、LDL、SBP、DBP、HbA1c and course.2.There was a significant difference between N group and DM group in TGF β1（P<0.01）.Compared the TGFβ1between A group and B group,there is statisticalsignificance （P<0.05）.With the degree of peripheral neuropathy aggravated,the serumlevels of TGF β1decreased.Compared the level of TGF β1,there was significantdifference among five groups,except for the comparison between A group and B₂group（P<0.01）.3.There were significant difference between DM group and N group in GSH andNF-κB（P<0.01）. With the degree of peripheral neuropathy aggravated,the serum levels ofGSH decreased,and the activity of NF-κB increased.There were significant differencesamong N、A、B₁、B₂and B₃group in GSH and NF-κB （p<0.05）.4．In type2diabetes mellitus groups,the serum TGFβ1level was negativelycorrelated with SBP （r=-0.223,p<0.05）、 course （r=-0.201,p<0.05）、NF-κB（r=-0.744,p<0.01）；and positively correlated with GSH（r=0.693,p<0.01）;there hadno significant correlation with age、HbA1c、BMI、DBP、TC、TG、LDL-C、BUN、Cr irrelevant.The serum GSH level was negatively correlated with course（r=-0.319,p<0.01）、NF-κB（r=-0.776,p<0.01）；;there had no significant correlation withage、HbA1c、BMI、SBPDBP、TC、TG、LDL-C、BUN、Cr irrelevant.The activity of NF-κB was positivelycorrelated with course（r=0.261,p<0.01）、cr（r=0.201,p<0.05）,and there had no significantcorrelation with age、HbA1c、BMI、SBP、DBP、TC、TG、LDL-C、BUN irrelevant.GSH was the independent related factor of the TGFβ1（r2=0.633,0.566）.5. with the degree of peripheral neuropathy aggravated, the DR rate increases, butthere had no relevance between the incidence of early DN and DPN progress.Conclusions:1. Patients with type2diabetes mellitus had higher serum TGFβ1level、NF-κBactivity and lower serum GSH level, With the degree of peripheral neuropathy aggravated,the serum levels of GSH and TGFβ1decreased,the activity of NF-κB increased. 2．Serum TGFβ1levels was negatively correlated with SBP、course、NF-κBï¼› andpositively with GSH. Serum GSH levels was negatively correlated with course、NF-κBactivity. The activity of NF-κB was positively with course and Cr.3. The serum TGFβ1level may benefit the early diagnosis of DPN, TGFβ1may playa role in the complicated pathophysiological process of diabetic peripheral neuropathy, andwe can take advantage of it to control the progress of diabetic peripheral neuropathy indiabetes patients.