CONTENT OF NITROGEN OXIDE AND ENDOTHELIN-1 IN BLOOD
PLASMA IN PATIENTS WITH DIABETES MALLITUS TYPE 1 WITH THE
DIFFERENT STAGES OF DIABETIC NEPHROPATHY
A.Pkhakadze, M.Neborachko, Ukrainian Scientific-practical center of
endocrine surgery, transplantation of endocrine organs and tissues (Kiev,
Ukraine)
Objectives. Endothelial dysfunction (ED) lies in basis of pathogenesis of
diabetic nephropathy (DN). However the question about causal-effective
relations between ED and DN is under discussion until now: is a disbalance
of vasoconstrictors and vasodilatators the starting moment of DN or
damage of endothelial and ED develops in progress of DN; on what stage
appears ED in diabetes mellitus (DM), what are the markers of early
manifestation of DN.
Research purpose: to study the changes in maintenance of nitrogen oxide
(NO) and endothelin-1 (E-1) in blood plasma of patients with DM type 1
depending on the stage of DN.
Methods. 56 patients with DM 1 type and 20 practically healthy people
were examined. In the number of examined patients, besides a control
group, are included the patients without the clinical signs of DN (group II),
and also the patients with different stages of DN – those, for whom
abnormality of kidney’s function has been already determined as
microalbuminuria (MAU) (group III), and also as proteinuria (group IV).
Middle age of patients, entered in the explored groups, did not differ
statistically for certain in comparison.
Results and discussion. The findings will be described that ED in the form
of an increase of level of endothelin-1 in plasma (0,16±0,02 phmol/ml) as
compared to a control group (0,06±0,01 phmol/ml) is already revealed for
patients with DM without MAU. At the same time a compensatory increase
of maintenance of nitrogen oxide (NO) (from 12,67±0,82 mkmol/l in a
control group to 15,00±1,03 mkmol/l for patients with DM and
normoalbuminuria) contributes to preservation of normal blood pressure
(BP). Presence of MAU (116,15±14,45 mg/day) for the patients of group III
is accompanied with the considerable increase of level of endothelin-1 – to
0,86±0,07 phmol/ml against a background of decline both absolute and,
especially relative maintenance of NO (10,48±0,18 mkmol/l) and increase of
systolic BP (to 132,63±3,7 mm Hg). ED intensifies as DN is in progress:
proteinuria (809,16±97,51 mg/day) is accompanied with high maintenance
of endothelin-1 (8,1±1,8 phmol/l), falling of level of NO to 9,87±0,53 mkmol/l
and
arterial
hypertension
(148,13±4,85mmHg
systolic
and
91,25±2,83mmHg – diastolic BP).
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