BACKGROUND Diabetes is a clinically common chronic disease,and its incidence has been increasing in recent years.Diabetes is believed to accelerate the process of atherosclerosis in patients,and abnormal endothelial f...BACKGROUND Diabetes is a clinically common chronic disease,and its incidence has been increasing in recent years.Diabetes is believed to accelerate the process of atherosclerosis in patients,and abnormal endothelial function is an important factor leading to diabetic kidney damage.AIM To investigate the efficacy of ligliptin in the treatment of type 2 diabetes mellitus(T2DM)with early renal injury and its effect on serum endogenous hydrogen sulfide(H2S),endothelial cell particles,and endothelial function.METHODS From January 2018 to April 2019,110 patients with T2DM and early kidney injury treated at our hospital were divided into an observation group(receiving ligliptin treatment,n=54)and a control group(receiving gliquidone therapy,n=56).Blood glucose and renal function before and after treatment were compared between the two groups.RESULTS The differences in fasting blood glucose,2 h blood glucose,and glycated hemoglobin were not statistically significant between the two groups after treatment.The urinary albumin excretion rate after treatment in the ligliptin group was 70.32±11.21μg/min,which was significantly lower than that of the gliquidone group(P=0.000).Serum endogenous H2S and endothelial cell microparticles of the ligliptin treatment group were 40.04±8.82 mol/L and 133.40±34.39,respectively,which were significantly lower than those of the gliquidone treatment group(P=0.000 for both);endothelin-dependent diastolic function and nitric oxide after treatment in the ligliptin group were 7.98%±1.22%and 190.78±30.32 mol/L,significantly higher than those of the gliquidone treatment group(P=0.000 for both).CONCLUSION Ligliptin treatment of T2DM with early renal injury has the same glucoselowering effect as gliquidone treatment.Ligliptin treatment has a better effect and it can significantly improve the renal function and vascular endothelial function of patients,and reduce serum endogenous H2S and endothelial cell particle levels.展开更多
Objective:To explore the protective effect of calcium dobesilate combined with benazepril therapy on renal injury in patients with early diabetic nephropathy and the possible molecular mechanisms.Methods:A total of 50...Objective:To explore the protective effect of calcium dobesilate combined with benazepril therapy on renal injury in patients with early diabetic nephropathy and the possible molecular mechanisms.Methods:A total of 50 patients with early diabetic nephropathy treated in our hospital between May 2012 and January 2016 were collected, and according to the random number table, the patients were divided into observation group (n=25) and control group (n=25). On the basis of conventional treatment, control group of patients received benazepril therapy, observation group of patients received calcium dobesilate combined with benazepril therapy, and the treatment lasted for 3 months. Before and after treatment, automatic biochemical analyzer was used to detect the levels of renal injury indexes in peripheral blood, RIA method was used to detect the levels of renal injury indexes in urine, ELISA method was used to detect the levels of renal fibrosis indexes and Western-blot method was used to detect the protein expression of TGF-β1/BMP-7 and Smad signaling pathway molecules in renal tissue. Results: Before treatment, differences in renal injury index levels, renal fibrosis index levels and signaling pathway molecule protein expression were not statistically significant between two groups of patients. After treatment, BUN, SCr andβ-TP levels in the peripheral blood as well as KIM-1 level in urine of observation group were lower than those of control group;renal fibrosis indexes TGF-β1, CTGF, TIMP-1, LN and HA levels in serum of observation group were lower than those of control group;TGF-β1 and Smad2/3 protein expression in renal tissue of observation group were lower than those of control group while Smad7 and BMP-7 protein expression were higher than those of control group.Conclusion: Calcium dobesilate combined with benazepril therapy can reduce the renal injury and inhibit the fibrosis process in patients with early diabetic nephropathy, and it achieves the above effect by regulating the TGF-β1/BMP-7 and Smad signaling pathway function.展开更多
目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)...目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)为金标准,将患者分成将2型糖尿病患者分成早期肾损伤组(n=78,20μg/min≤UAER≤200μg/min)、糖尿病肾病组(n=28,UAER>200μg/min)和正常组(n=215,UAER<20μg/min)。比较3组外周血CCN1表达,Pearson法测定UAER与外周血CCN1的相关性,使用ROC曲线评估外周血CCN1对2型糖尿病早期肾损伤和糖尿病肾病的预测价值。单因素分析基线资料,多因素Logistic回归分析确定早期肾损伤或糖尿病肾病的影响因素。结果糖尿病肾病组CCN1和UAER水平高于早期肾损伤组和正常组;早期肾损伤组的CCN1和UAER水平也高于正常组(P<0.05);外周血CCN1与UAER呈正相关(r=0.916,P<0.001)。以外周血CCN1为检验变量,以是否发生早期肾损伤为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为1.59μg/L,其对应的敏感度为85.85%,特异度为73.02%,AUC为0.871(95%CI:0.831~0.903)。以外周血CCN1为检验变量,以是否发生糖尿病肾病为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为3.41μg/L,其对应的敏感度为71.43%,特异度为73.72%,AUC为0.761(95%CI:0.707~0.813)。糖尿病肾病组、早期肾损伤组和正常组的病程、高血压、高血脂、收缩压、FPG、糖化血红蛋白(glycated hemoglobin,HbA1c)、尿酸(uric acid,UA)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)和低密度脂蛋白(low-density lipoprotein,LDL)等方面比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,病程(OR=1.740,95%CI:1.180~2.565)、收缩压(OR=1.943,95%CI:1.267~2.978)、高血脂(OR=1.654,95%CI:1.310~2.088)、FPG(OR=2.776,95%CI:1.260~6.116)、UA(OR=2.228,95%CI:1.174~4.229)和CCN1(OR=3.744,95%CI:1.709~8.200)是2型糖尿病早期肾损伤发生的影响因素(P<0.05)。Logistic回归分析结果显示,病程(OR=1.752,95%CI:1.177~2.609)、收缩压(OR=1.818,95%CI:1.034~3.198)、高血脂(OR=1.680,95%CI:1.320~2.138)、FPG(OR=2.389,95%CI:1.519~3.758)、UA(OR=1.260,95%CI:1.038~1.530)和CCN1(OR=3.815,95%CI:1.636~8.897)是糖尿病肾病发生的影响因素(P<0.05)。结论外周血CCN1与尿液微量白蛋白排泄率呈正相关,是早期肾损伤或糖尿病肾病的危险因素,并可应用于预测早期肾损伤或糖尿病肾病的发生,值得临床进一步研究并推广。展开更多
Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred s...Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred seventy-nine patients with T2DM undergonging elective cardiac catheterization from Dongguan Kanghua Hospital were recruited. Patients were classified into quartiles based on HbAlc （ 〈 6.30%, 6.30- 6.70%, 6.71-7.70, and 〉 7.70%）. Baseline data, CI-AKI incidence and in-hospital outcomes were compared between the groups. Logistic regression was used to assess the relationship between HbAlc and CI-AKI. Results CI-AKI occurred in 26 （9.3%）patients. CI-AKI incidences of HbAlc quartiles were 4.6 %（3/65）, 2.8%（2/71）, 12.3%（9/73） and 17.1%（12/70） （P = 0.003）, respectively. There were no significant differences in in-hospital death or required renal replacement therapy among the four groups. Univariate logistic analysis showed that HbAlc was related with CI-AKI （OR = 1.319, 95%CI： 1.078-1.615, P = 0.007）. Multivariate analysis found that after adjusting eGFR 〈 60 ml/min/1.73 m2, age 〉 70 years and anemia, I-IbAlc 〉17% was still a significant independent risk factor for CI-AKI in patients with T2DM. Conclusions HbAlc is significantly associated with CI-AKI. HbAlc ≥ 7% may increase the risk of CI-AKI in patients with T2DM undergoing elective cardiac catheterization.展开更多
文摘BACKGROUND Diabetes is a clinically common chronic disease,and its incidence has been increasing in recent years.Diabetes is believed to accelerate the process of atherosclerosis in patients,and abnormal endothelial function is an important factor leading to diabetic kidney damage.AIM To investigate the efficacy of ligliptin in the treatment of type 2 diabetes mellitus(T2DM)with early renal injury and its effect on serum endogenous hydrogen sulfide(H2S),endothelial cell particles,and endothelial function.METHODS From January 2018 to April 2019,110 patients with T2DM and early kidney injury treated at our hospital were divided into an observation group(receiving ligliptin treatment,n=54)and a control group(receiving gliquidone therapy,n=56).Blood glucose and renal function before and after treatment were compared between the two groups.RESULTS The differences in fasting blood glucose,2 h blood glucose,and glycated hemoglobin were not statistically significant between the two groups after treatment.The urinary albumin excretion rate after treatment in the ligliptin group was 70.32±11.21μg/min,which was significantly lower than that of the gliquidone group(P=0.000).Serum endogenous H2S and endothelial cell microparticles of the ligliptin treatment group were 40.04±8.82 mol/L and 133.40±34.39,respectively,which were significantly lower than those of the gliquidone treatment group(P=0.000 for both);endothelin-dependent diastolic function and nitric oxide after treatment in the ligliptin group were 7.98%±1.22%and 190.78±30.32 mol/L,significantly higher than those of the gliquidone treatment group(P=0.000 for both).CONCLUSION Ligliptin treatment of T2DM with early renal injury has the same glucoselowering effect as gliquidone treatment.Ligliptin treatment has a better effect and it can significantly improve the renal function and vascular endothelial function of patients,and reduce serum endogenous H2S and endothelial cell particle levels.
文摘Objective:To explore the protective effect of calcium dobesilate combined with benazepril therapy on renal injury in patients with early diabetic nephropathy and the possible molecular mechanisms.Methods:A total of 50 patients with early diabetic nephropathy treated in our hospital between May 2012 and January 2016 were collected, and according to the random number table, the patients were divided into observation group (n=25) and control group (n=25). On the basis of conventional treatment, control group of patients received benazepril therapy, observation group of patients received calcium dobesilate combined with benazepril therapy, and the treatment lasted for 3 months. Before and after treatment, automatic biochemical analyzer was used to detect the levels of renal injury indexes in peripheral blood, RIA method was used to detect the levels of renal injury indexes in urine, ELISA method was used to detect the levels of renal fibrosis indexes and Western-blot method was used to detect the protein expression of TGF-β1/BMP-7 and Smad signaling pathway molecules in renal tissue. Results: Before treatment, differences in renal injury index levels, renal fibrosis index levels and signaling pathway molecule protein expression were not statistically significant between two groups of patients. After treatment, BUN, SCr andβ-TP levels in the peripheral blood as well as KIM-1 level in urine of observation group were lower than those of control group;renal fibrosis indexes TGF-β1, CTGF, TIMP-1, LN and HA levels in serum of observation group were lower than those of control group;TGF-β1 and Smad2/3 protein expression in renal tissue of observation group were lower than those of control group while Smad7 and BMP-7 protein expression were higher than those of control group.Conclusion: Calcium dobesilate combined with benazepril therapy can reduce the renal injury and inhibit the fibrosis process in patients with early diabetic nephropathy, and it achieves the above effect by regulating the TGF-β1/BMP-7 and Smad signaling pathway function.
文摘目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)为金标准,将患者分成将2型糖尿病患者分成早期肾损伤组(n=78,20μg/min≤UAER≤200μg/min)、糖尿病肾病组(n=28,UAER>200μg/min)和正常组(n=215,UAER<20μg/min)。比较3组外周血CCN1表达,Pearson法测定UAER与外周血CCN1的相关性,使用ROC曲线评估外周血CCN1对2型糖尿病早期肾损伤和糖尿病肾病的预测价值。单因素分析基线资料,多因素Logistic回归分析确定早期肾损伤或糖尿病肾病的影响因素。结果糖尿病肾病组CCN1和UAER水平高于早期肾损伤组和正常组;早期肾损伤组的CCN1和UAER水平也高于正常组(P<0.05);外周血CCN1与UAER呈正相关(r=0.916,P<0.001)。以外周血CCN1为检验变量,以是否发生早期肾损伤为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为1.59μg/L,其对应的敏感度为85.85%,特异度为73.02%,AUC为0.871(95%CI:0.831~0.903)。以外周血CCN1为检验变量,以是否发生糖尿病肾病为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为3.41μg/L,其对应的敏感度为71.43%,特异度为73.72%,AUC为0.761(95%CI:0.707~0.813)。糖尿病肾病组、早期肾损伤组和正常组的病程、高血压、高血脂、收缩压、FPG、糖化血红蛋白(glycated hemoglobin,HbA1c)、尿酸(uric acid,UA)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)和低密度脂蛋白(low-density lipoprotein,LDL)等方面比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,病程(OR=1.740,95%CI:1.180~2.565)、收缩压(OR=1.943,95%CI:1.267~2.978)、高血脂(OR=1.654,95%CI:1.310~2.088)、FPG(OR=2.776,95%CI:1.260~6.116)、UA(OR=2.228,95%CI:1.174~4.229)和CCN1(OR=3.744,95%CI:1.709~8.200)是2型糖尿病早期肾损伤发生的影响因素(P<0.05)。Logistic回归分析结果显示,病程(OR=1.752,95%CI:1.177~2.609)、收缩压(OR=1.818,95%CI:1.034~3.198)、高血脂(OR=1.680,95%CI:1.320~2.138)、FPG(OR=2.389,95%CI:1.519~3.758)、UA(OR=1.260,95%CI:1.038~1.530)和CCN1(OR=3.815,95%CI:1.636~8.897)是糖尿病肾病发生的影响因素(P<0.05)。结论外周血CCN1与尿液微量白蛋白排泄率呈正相关,是早期肾损伤或糖尿病肾病的危险因素,并可应用于预测早期肾损伤或糖尿病肾病的发生,值得临床进一步研究并推广。
文摘Background There were few studies to explore the relationship between hemoglobin Alc （HbAlc）and contrast-induced acute renal injury （CI-AKI）in patients with type 2 diabetes mellitus （T2DM）. Methods Two hundred seventy-nine patients with T2DM undergonging elective cardiac catheterization from Dongguan Kanghua Hospital were recruited. Patients were classified into quartiles based on HbAlc （ 〈 6.30%, 6.30- 6.70%, 6.71-7.70, and 〉 7.70%）. Baseline data, CI-AKI incidence and in-hospital outcomes were compared between the groups. Logistic regression was used to assess the relationship between HbAlc and CI-AKI. Results CI-AKI occurred in 26 （9.3%）patients. CI-AKI incidences of HbAlc quartiles were 4.6 %（3/65）, 2.8%（2/71）, 12.3%（9/73） and 17.1%（12/70） （P = 0.003）, respectively. There were no significant differences in in-hospital death or required renal replacement therapy among the four groups. Univariate logistic analysis showed that HbAlc was related with CI-AKI （OR = 1.319, 95%CI： 1.078-1.615, P = 0.007）. Multivariate analysis found that after adjusting eGFR 〈 60 ml/min/1.73 m2, age 〉 70 years and anemia, I-IbAlc 〉17% was still a significant independent risk factor for CI-AKI in patients with T2DM. Conclusions HbAlc is significantly associated with CI-AKI. HbAlc ≥ 7% may increase the risk of CI-AKI in patients with T2DM undergoing elective cardiac catheterization.
