URINARY EXCRETION OF PROFIBROTIC AND ANTIFIBROTIC GROWTH FACTORS IN TYPE 1 DIABETIC PATIENTS: THE RELATION WITH DIABETIC NEPHROPATHY


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Abstract

Aim. To assess the relation between urinary excretion of profibrotic and antifibrotic growth factors, albuminuria and glomerular fibrosis in type 1 diabetic patients. Materials and methods. 64 patients with diabetes were examined, including 25 ones with normal albumin excretion rate (AER), 30 microalbuminuric and 9 macroalbuminuric patients. Urinary excretion of type IV collagen, transforming growth factor-β1 (TGF-ß1), tumor necrosis factor-α (TNF-α), fibroblast growth factor-2 (FGF-2), hepatocyte growth factor (HGF) and bone morphogenetic protein-7 (BMP-7) was determined by ELISA and compared to control (10 healthy subjects). Renal biopsy specimens were assessed in 7 patients with normal AER and in 14 microalbuminuric patients. Results. Type IV collagen, TGF-β1 and TNF-α excretion was increased significantly in patients with micro- and macroalbuminuria as compared to control (all p<0.05). Excretion of FGF-2 was increased in macroalbuminuric patients only (p=0.003). No marked changes in excretion of antifibrotic growth factors (HGF and BMP-7) were observed. TNF-α and FGF-2 correlated positively with urinary type IV collagen (r=0.37 and r=0.31, respectively). The presence of glomerular fibrosis in renal biopsy specimens was associated with higher excretion of TGF-ß1, TNF-α and FGF-2 (all p<0.05). Conclusion. The results suggest that unbalance between profibrotic and antifibrotic growth factors in the kidneys plays an important role in pathogenesis of diabetic nephropathy. Urinary TGF-ß1, TNF-α and FGF-2 may offer new possibilities for detection of renal fibrosis in diabetic patients.

About the authors

I A Bondar

Novosibirsk State Medical University

Chair of Endocrinology

V V Klimontov

Novosibirsk State Medical University

Email: klimontov@mail.ru
Chair of Endocrinology

E M Parfentieva

Novosibirsk State Medical University

Chair of Endocrinology

V V Romanov

Diagnostic Laboratory «In vitro»

канд. мед. наук, зав. лаб. Novosibirsk

A P Nadeev

Novosibirsk State Medical University

Chair of Pathology

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