Correlation Of Serum LPA/OPN And TGF-?1 In Type 2 Diabetic Mellitus Patients With Different Urine Albumin Excretion Rates

Objective: As a common microvascular complication of type 2 diabetes mellitus(T2DM),diabetic kidney disease(DKD)is the leading cause of end-stage renal disease and causes severe social and economic burdens.Therefore,the discovery of specific and sensitive biomarkers and the early diagnosis and prevention of DKD are particularly important for patients with diabetes mellitus.In this article,the serum lysophosphatidic acid(LPA),osteopontin(OPN)and transforming growth factor-?1(TGF-?1)levels and their correlations in T2 DM patients with different urine albumin excretion rates were studied.Methods: The subjects of the study were the patients with type 2 diabetes who visited our hospital for the first time and were hospitalized,all of which met the conditions for admission.The subjects were divided into three groups according to the urine albumin to creatinine ratio(UACR): 105 cases of normal albuminuria group(group D1),UACR <30mg/g;105 cases of microalbuminuria group(group D2),UACR 30 ~ 300mg/g and 103 cases of large albuminuria group(group D3),UACR>300mg/g.A total of 104 healthy people matched by gender and age at the same period were selected as the normal control group(group N).ELISA was used to determine LPA,OPN and TGF-?1.Results: Serum LPA,OPN and TGF-?1 levels were higher in T2 DM patients than in healthy controls(P <0.05).And with the increase of UACR,the levels of LPA,OPN and TGF-?1 increased sequentially in D1,D2,and D3 groups,and the difference was statistically significant(P <0.05).Pearson correlation analysis showed that serum LPA levels were positively correlated with SBP,DBP,UACR,Hb A1 C,TG,TC,UA,OPN,and TGF-?1 levels(r = 0.244,0.104,0.517,0.479,0.387,0.167,0.163,0.637,0.729,P <0.05),and were negatively correlated with HDL-C levels(r =-0.141,P <0.01).The results of multiple linear stepwise regression analysis showed that TG,Hb A1 C,UACR,OPN and TGF-?1 were independent risk factors for LPA.Conclusion: Serum LPA is significantly positively correlated with OPN and TGF-?1 levels.OPN and TGF-?1 are independent risk factors for LPA.With the increase of UACR levels,serum LPA,OPN and TGF-?1 levels gradually increase,suggesting that LPA may play a role in inflammation and fibrosis-related processes by regulating the expression levels of OPN and TGF-?1,and participate in the disease progression of DKD.Serum LPA may be a new biomarker for early diagnosis of DKD and reflecting the severity of kidney injury.