热休克蛋白27水平作为早期糖尿病肾病预测因子的评估

Muhammad Irfan, Shabir Ahmed, Adil Ramzan, Nosheen Wasee, Nuvair Zia, Nargis Anjum
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摘要

目的:本研究的目的是了解合并和不合并糖尿病肾病的糖尿病患者中热休克蛋白27的水平,并评价热休克蛋白27作为早期诊断生物标志物在进展性糖尿病肾病中的功能作用。研究设计:病例对照研究。研究地点和时间:本研究于2019年3月至2020年9月在卡拉奇真纳研究生医学中心(JPMC)基础医学研究所(BMSI)生理学系进行。方法:共有105名年龄在30-50岁之间的参与者被分为三组:A组(n=35)糖尿病患者-糖尿病史< 5年,无任何DN迹象;B组(n=35)为糖尿病病史>5年且尿微量白蛋白水平< 30 mg/dl的糖尿病患者,C组(n=35)为健康人群。对所有研究参与者进行了详细的病史、人体测量、BMI、血清血糖、血清尿素、血清肌酐、BUN、尿白蛋白和血清热休克蛋白27的评估。结果:与c组相比,a组患者HSP-27水平升高(p<0.001)。与c组相比,b组HSP-27水平升高(p<0.001),提示早期肾实质损伤。HSP-27与肌酐有很强的相关性(r=0.69;p < 0.001), HbA1c (r =0.72;P <0.001)和尿素(r = 0.72;P <0.001)。HSP-27与微量白蛋白呈显著正相关(r = 0.86;P < 0.001)。结论:HSP-27水平升高与肾损伤进展伴或不伴肾功能下降有关。这些发现可能提示并认识到热休克蛋白27是早期糖尿病肾病的关键诊断标志物。关键词:糖尿病,糖尿病肾病,热休克蛋白27
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Evaluation Of Heat Shock Protein-27 Levels as A Predictor of Diabetic Nephropathy in Early Diabetics
Objective: The current study objective is to find out the levels of heat shock protein-27 in diabetes patients with and without diabetic nephropathy, and to appraise the functional role of HSP-27 as an early diagnostic biomarker in progressive diabetic nephropathy. Study Design: Case control study. Place and Duration of Study:  The current study was conducted in physiology department, Basic Medical Science Institute (BMSI), Jinnah Post-Graduate Medical Center (JPMC), Karachi from March 2019 to September 2020. Methodology: A total 105 participants between 30-50 years of age were separated into three groups: Group A (n=35) diabetic-patients with history of diabetes < 5 years without any sign of DN; Group B (n=35) diabetic patients with history of diabetes >5 years duration of diabetes and microalbumin levels < 30 mg/dl in urine and Group C (n=35) healthy individuals. All this study participants were gone through detailed history, anthropometric measurement, BMI, serum blood sugar, serum urea, serum creatinine, BUN, urinary albumin, and serum HSP-27 were estimated. Results: Elevated levels of HSP-27 were seen in group-A patients as compared to group-C (p<0.001). Elevated levels of HSP-27 were presented in group-B as compared with group-C (p<0.001) which signify early renal parenchyma injury. Strong association had been seen for HSP-27 with creatinine (r=0.69; p < 0.001), and HbA1c (r =0.72; p <0.001) and urea (r = 0.72; p <0.001) in all these participants. While statistical highly significant and strong positive association were reported for HSP-27 with microalbumin (r = 0.86; p< 0.001) in all participants. Conclusion: Elevated levels of HSP-27 with progression of renal injury with or without declining of renal function is seen in current study. These findings perhaps suggest and recognizing HSP-27 as key diagnostic marker for diabetic nephropathy in early diabetics. KEYWORDS: Diabetes Mellitus, Diabetic Nephropathy, HSP-27.
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