Abstract: Objective To investigate the expression of AMPKα1 / TLR4 pathway in the elderly patients with diabetic nephropathy and the correlation with the levels of nuclear factor-κB (NF-κB) and transforming growth factor-β1 (TGF-β1). Methods A total of 126 elderly patients with diabetic nephropathy confirmed by renal biopsy from March 2017 to May 2019 were selected as the observation group; And 81 elderly patients (non diabetic nephropathy) who underwent nephrectomy at the same time were selected as the control group. The levels of AMPKα 1 / TLR4 mRNA in different tissues were measured by real-time polymerase chain reaction and hematoxylin-eosin (HE) staining, and the levels of NF-κB and TGF-β1 in the two groups were measured by enzyme-linked immunosorbent assay. The correlations between AMPKα1 / TLR4 mRNA and NF-κB, TGF-β1 were analyzed by Pearson correlation coefficient. Results The level of AMPKα1/TLR4 mRNA in the observation group was lower than that in the control group (P<0.01). HE staining showed that the glomerular capillary basement in the observation group was diffusely thickened, accompanied with fibrosis, and the intima of small artery wall was thickened; While in the control group, the glomeruli and renal tubules showed no obvious pathological changes and no fibrosis. The levels of NF-κB and TGF-β1 in the observation group were higher than those in the control group. Pearson correlation analysis showed that AMPK α1 / TLR4 mRNA level was negatively correlated with NF-κB and TGF-β1 levels in the elderly patients with diabetic nephropathy (P < 0.05). Conclusions The expression of AMPK α1 / TLR4, NF-κB and TGF-β1 are abnormal in the elderly patients with diabetic nephropathy. They might directly participate in the occurrence and development of the disease.

Key words: adenylate-activated protein kinase α1, Toll-like receptor 4, diabetic nephropathy, peripheral blood nuclear factor-κB, transforming growth factor-β1, aged