Elevated fibrinogen and the relation to acute phase response in diabetic nephropathy

被引:55
作者
Myrup, B
deMaat, M
Rossing, P
Gram, J
Kluft, C
Jespersen, J
机构
[1] TNO PG,GAUBIUS LAB,LEIDEN,NETHERLANDS
[2] S JUTLAND UNIV CTR,THROMBOSIS RES INST,ESBJERG,DENMARK
关键词
insulin-dependent diabetes mellitus; diabetic nephropathy; cardiovascular disease; fibrinogen; C-reactive protein; interleukin-6;
D O I
10.1016/0049-3848(96)00021-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Insulin-dependent diabetic patients with nephropathy have a high risk of cardiovascular disease. Chronic inflammation is a part of the pathogenesis of atherosclerosis, and presently we have studied the relation between the inflammatory state, measured as levels of interleukin-6 and C-reactive protein and fibrinogen in diabetic nephropathy. Thirty-three insulin-dependent diabetic patients with diabetic nephropathy (urinary albumin excretion rate(AER) > 300 mg/24-h) and 22 patients with incipient diabetic nephropathy (AER 30-300 mg/24-h) were compared with 14 non-diabetic controls and 17 diabetic patients with normal AER (< 30 mg/24-h). Fibrinogen was significantly higher in diabetic nephropathy than in non-diabetic controls and diabetic patients with normal AER (median 8.1, range (5.4-15.6) mu mol/l vs. 6.6 (5.0-12.1) mu mol/l, p<0.05, and 6.2 (5.0-9.0) mu mol/l, p<0.005, respectively), while C-reactive protein did not deviate between groups. Interleukin-6 was significantly elevated in all insulin-dependent diabetic patients (diabetic nephropathy (3.2 (1.0-14.5) pg/ml, p<0.005), incipient nephropathy (3.7 (1.0-22.9) pg/ml, p<0.005) and diabetic patients with normal AER (2.7 (1.0-9.0) pg/ml, p<0.05) compared with non-diabetic controls (1.2 (1.0-6.2) pg/ml)). When fibrinogen was adjusted for interleukin-6, C-reactive protein or both, the level of fibrinogen was still higher in patients with diabetic nephropathy than in patients without nephropathy (p<0.05), which suggests that inflammation is not the only mechanism that increases fibrinogen levels in patients with diabetic nephropathy.
引用
收藏
页码:485 / 490
页数:6
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