The Study Of The Varied Serum AGEs In Diabetic Kidney Disease And Analysis Of TCM Syndromes

AGEs play a significant role in development of diabetic kidney disease,which cause hemodynamic change,oxidative stress,glucose metabolic disturbance and inflammatory reaction,were the main pathological mechanism of diabetic and its complications. Endoplasmic reticulum stress is a key factor in the pathogenesis of DKD.AGEs not only a etiological factors but also a pathology products,which were closely related to blood stasis,phlegm,damp turbidity.therefore,study of the varied serum AGEs in diabetic kidney disease may help to analysis of Chinese medicine dialectical type.Experimental research:the distribution of serum AGEs in diabetic kidney disease and the analysis of TCM syndromesObjective1. To observe the variety of serum AGEs in diabetic kidney disease;2. To construe the syndrome distribution of TCM syndromes;3. To construe the correlation of AGEs with TCM syndromes.Methods60cases of patients and20cases of healthy people were collected and divided into four groups according to the albumin-creatinine ratio (ACR) and serum creatinine (Scr):①diabetes mellitus group (DM), ACR<30mg/g;②diabetes with albuminuria group (DKD1), ACR>30mg/g,Scr<132μmol/l;ヾiabetes with renal failure (DKD2), Scr<132pmol/l;④normal control group (NC).Collect the clinical information, include sex,age, Scr,HbAlc, TG,TC, HDL, LDL, CRP, et al. And then analyze the TCM dialectical type; Measure the Serum AGEs concentration by ELISA. Results1. There was not any difference of age,HbAlc among three diabetic groups.(P>0.05).There were significant difference of AGEs, Cr between the NC and DKD2groups (P <0.05).2. Serum AGEs in DKD2(180.56±72.31ng/l)>DKD1(113.14±52.20ng/l)>DM (80.63±43.12ng/l)>NC (23.52±8.46ng/l), There were significant difference among the four groups (P<0.05).3. AGEs had notable correlation with Scr, and had a negative correlation with GFR (P <0.01).4. In the four deficiency syndromes of DKD, Yin and Yang deficiency was absent. Qi and Yin deficiency(28cases) was noticeably higher than the other two (P<0.01).5. All of the deficiency syndromes of DKD, Serum AGEs in syndrome of Qi and Yin deficiency(122.53±62.45ng/1),Yin deficiency-Dry Heat (126.47±56.66ng/1) were apparently higher than NC,but there were not any difference among the diabetic groups, namely AGEs had not correlation with Chinese medicine dialectical type in DKD.(P<0.01). Conclusion1. In type1and type2diabetic patients, serum AGEs levels were notable increased compared with non-diabetic control subjects.2. Diabetic patients with impaired renal function had much AGEs in serum than diabetic patients without impaired renal function.3. Serum AGEs had positive correlation with the grade of renal insufficiency;4. Serum AGEs can be available to earlier detect diabetes, and to assess the grade of impaired renal function.5. Qi and Yin deficiency, Yin deficiency-Dry Heat,Blood stasis were the most common basic pathogenesis in diabetic kidney disease;6. Serum AGEs did not have relativity with TCM syndromes in DKD, which could not provide the help to analysis of Chinese medicine dialectical type. Exper imental research:The Mechan i sm of AGE-BSA-i nduced human renal proximal tubular epithelial cell injuryObjectiveTo investigate the mechanism of AGE-BSA-induced human renal proximal tubular epithelial cell injury and endoplasmic reticulum stress signaling pathway.MethodsDifferent AGE-BSA concentrations (0、25、50、100、200、400mM) and different time points(0,12,24,36,48,2h) were used to stimulate HK-2cells. The key proteins of endoplasmic reticulum stress (GRP78) were measured by Western blot analysis.ResultWestern blot showed that the expression of GRP78were raised as the time extensing and the concentration increasing, compared with normal control ground, stimulate time points(48h,72h) and concentration point(400mM) had significant difference(P<0.05),that is to say, AGE-BSA-induced human renal proximal tubular epithelial cell injury has a close relation with endoplasmic reticulum stress signaling pathway.Conclusion1.Endoplasmic reticulum stress signaling pathway can be activated by the stimulation of AGE-BSA.2.The damnification of AGE-BSA on human proximal renal tubular epithelial cell showed dose-dependant and time-dependant.