糖尿病控制差會損害Tamm-Horsfall蛋白對晶體聚集抑制的功能
盧艷金1,3、曾一修1,2
亞東紀念醫院 外科部 1創傷科，2泌尿科; 3醫學研究部
Poor Diabetes Control Impair the Function of Tamm-Horsfall Protein on Crystal Aggregation Inhibition
Yen-Chin Lu1,3, Yi-Shiou Tseng1,2
Divisions of Traumatology1 and Urology2, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
Department of Medical Research3, Far Eastern Memorial Hospital, New Taipei City, Taiwan
Purpose: Tamm-Horsfall protein (THP) is the most abundant protein in human urine. It plays an important role in preventing kidney stone formation. It has been studied that the stone former with diabetes mellitus (DM) had lower urine THP production, but the function of crystal aggregation inhibition from THP is still unknown. The aim of our study is to investigate the function of THP anti-aggregation in stone formers with DM.
Materials and Methods: There are 7 stone formers with DM, five patients with HbA1c ≧6.5% and 2 patients with HbA1c <6.5%. We used salt precipitation method to isolate THP from 24-hour urine. Urine THP levels were measured by ELISA to estimate daily amount. The anti-aggregation assay included the interaction between calcium oxalate monohydrate (COM) crystal and THP, and measure of absorbance (optical density; OD) at λ620 nm by a spectrophotometer.
Results: There was significantly lower function of aggregation inhibition in the patients with HbA1c ≧6.5% than the patients with HbA1c <6.5% (25.60% vs 46.07%). The daily extraction amount of urine THP was reported no difference between two groups (6.52 mg/day vs 6.09 mg/day).
Conclusions: Our study found that stone former with relatively poor DM control had impaired anti-aggregation function of THP. Impaired anti-aggregation function indicated more crystal formation and recurrent kidney stone disease.