Abstract

This study is to investigate the changes of serum anti-aging protein Klotho levels and its correlation with other serum indexes in type 2 diabetes mellitus (T2DM)patients at different stages of diabetic kidney disease (DN). A total of 462 cases with T2DM were divided into three groups according to the level of urinary albumin to creatinine ratio (UACR): normoal buminuric group (group N, UACR 300 mg/g, n=124), while 160 healthy volunteers age-matched were selected as the normal control (NC)group, 78 males and 82 females, age (51 ± 6)yrs. The levels of serum soluble-Klotho (sKlotho), neutrophil gelatinase-associated lipocalin (NGAL), 8- isoprostane prostaglandin F2α (8-iso-PGF2α), monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-α (TNF-α)and transforming growth factor-β 1 (TGF-β1)were determined by a quantitative sandwich enzyme-linked immuno sorbent assay (ELISA)in all the cases and 160 subjects of control (group NC). Multiple regression analysis was used to analyze the relationship between the various indexes of serum and urinary albumin. The results showed as following: (1)Compared with group NC, the levels of serum sKlotho in group N was obviously decreased (377.2 (359.5-394.9) ng/L vs 246.1 (236.1-256.2)ng/L, P<0.05), especially in group L (90.1 (83.1-97.0)ng/L). (2)The serum sKlotho levels were significantly negative in correlation with NGAL and UACR levels (r=-0.491, -0.732, bothP<0.05), but positively correlated with estimated glomerular filtration rate (eGFR, r=0.344, P<0.05). The levels of serum sKlotho was negatively correlated to the levels of serum 8-Iso-PGF2α, MCP-1, TNF-α, TGF-β1 (r=-0.437, -0.358, -0.422, -0.461, all P<0.05). The results suggest that the serum levels of Klotho may become new biological maker proteins of early diagnosing DN in T2DM. The mechanisms may be involved in oxidative stress related to inflammation and renal fibrosis. Key words: Diabetic nephropathies; Albuminuria; Sirtuins

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