Clinical studies, such as the Diabetes Control and Complications Trial (DCCT) in subjects with type-1 diabetes [1] and the UK Prospective Diabetes Study (UKPDS) in subjects with type-2 diabetes [2], clearly link hyperglycemia to diabetic nephropathy. Furthermore, the maintenance of normoglycemia for 10 years by pancreatic transplantation reduced glomerular pathological changes in 8 subjects with type-1 diabetes [3]. Therefore, the understanding of the hyperglycemia-related molecular pathogenesis of diabetic nephropathy is truly needed to provide a further insight into therapeutic strategies for diabetic nephropathy.Diabetic nephropathy is characterized histologically by an accumulation of extracellular matrix (ECM) proteins in the glomerular mesangium [4,5]. Functionally, an increase in glomerular filtration rates, glomerular hyperfiltration, found in the early phase of diabetes has been proposed to be related to the future development of diabetic nephropathy [6,7]. These abnormalities could be caused by functional changes in the diabetic glomeruli, particularly in glomerular mesangial cells, because mesangial cells were found to be capable of producing ECM proteins [8,9] and regulating glomerular filtration rates through their contractility [10,11]. An enhancement of the production of type-IV collagen and fibronectin [12][13][14], a reduction in the contractile responsiveness to angiotensin II (ANG II) [15][16][17] and an overproduction of vasorelaxing eicosanoids [18][19][20] have been shown in diabetic glomeruli and mesangial cells cultured under high-glucose conditions. These functional changes in glomeruli and mesangial cells in diabetes are thought to be caused by metabolic abnormalities in the glomeruli and mesangial cells specific to diabetes. In this review, the relationship between the metabolic abnormalities and the functional disturbance of mesangial cells in the diabetic milieu is described with a special Downloaded by: Fudan University Library 61.129.42.15 -5/15/2015 6:44:27 AM