Abstract: Objective To explore the levels and their possible effects of serum von Willebrand factor (vWF) and vWF lyase (ADAMTS13) in patients with diabetic nephropathy (DN). Methods Fifty cases of healthy physical examination (the normal control group) and 144 patients with type 2 diabetes (the T2DM group) were selected in this study. According to the ratio of urine microalbumin to urine creatinine (ACR), the diabetic T2DM patients were divided into the simple diabetes group (n=42, ACR＜30 mg/g), the microalbuminuria group (n=56, 30 mg/g≤ACR˂300 mg/g), and the macroalbuminuria group (n=46, ACR≥300 mg/g). The immunoturbidimetric method was used to detect vWF levels. The double antibody sandwich method was used to detect ADAMTS13 level, creatinine (sCr), urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c). The glomerular filtration rate (eGFR), D-Dimer and fibrinogen (Fib) were estimated. Results HbA1c, Fib, D-dimer and vWF increased successively in the normal control group, the T2DM group, the microalbuminuria group and the macroalbuminuria group, while ADAMTS13 decreased in turn (P＜0.05). Multiple linear regression analysis showed that albumin and D-dimer were the main factors affecting serum vWF, and D-dimer was the main factor affecting ADAMTS13 levels. ROC curve analysis showed that vWF was more sensitive in diagnosing DN renal damage, while D-dimer had more balanced sensitivity and specificity in the diagnosis of DN renal damage, and specificity was more advantage. Conclusion Serum vWF and ADAMTS13 may play an important role in the occurrence and development of DN, and their levels can be used as clinical indicators for the early diagnosis and prediction of DN.

Key words: diabetic nephropathies, diabetes mellitus, type 2, von Willebrand factor, ADAMTS13 protein, albuminuria