Association between the levels of serum inflammatory cytokines high-mobility group box-1, insulin-like growth factor-1, vascular endothelial growth factor 165 and progression of diabetic nephropathy / 中华肾脏病杂志

ABSTRACT

Objectives To determine the association between serum levels of high-mobility group box-1 (HMGB1),insulin-like growth factor-1 (IGF-1),vascular endothelial growth factor 165 (VEGF165) and occurrence and development of diabetic nephropathy (DN).Methods A total of 136 patients diagnosed as diabetic nephropathy (DN group) in Huai'an First People's Hospital between January 2016 to January 2018 were randomly selected in the study,including microalbuminuria group (n=62),macroalbuminuria group (n=50) and renal insufficiency group (n=24).Meanwhile,115 healthy examiners during the same period were collected as normal control group.Serum glucose,serum total cholesterol (TC),serum triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) and urinary albumin/urine creatinine ratio (UAlb/Cr) were detected inall subjects.Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the serum concentrations of HMGB1,IGF-1 and VEGF165.Pearson correlation test was used to analyze the correlation between serum HMGB1,IGF-1 and VEGF165.Logistic ordered multi-classification regression was used to analyze the risk factors of DN progression,and the receiver operating characteristic curve (ROC) was drawn to evaluate the clinical predictive value of HMGB1,IGF-1 and VEGF165 in the progression of DN.Results The concentrations of serum HMGB1,IGF-1 and VEGF165 in DN patients were significantly higher than those in the control group (all P ＜ 0.05).There was a positive association between HMGB1 and IGF-1,HMGB1 and VEGF165,IGF-1 and VEGF165 (all P ＜ 0.01).Logistic regression analysis showed that elevated levels of HMGB1,IGF-1 and VEGF165 were independent risk factors for DN progression (OR=5.50,1.05,1.24,all P ＜ 0.05).The sensitivity,specificity and area under ROC curve of combined detection of HMGB1,IGF-1 and VEGF165 were higher than HMGB1,IGF-1 and VEGF165 alone (AUC=0.989,0.984,0.942,0.878,P ＜ 0.05).Conclusions The serum levels of HMGB1,IGF-1 and VEGF165 are related to the severity of DN.The clinical predictive value of combined detection of HMGB1,IGF-1 and VEGF165 for DN progression is superior to that of single index detection of HMGB1,IGF-1 and VEGF165.