ABSTRACT
Objective:To observe the expression of serum nuclear factor-κB (NF-κB) and monocyte chemotactic protein-1 (MCP-1) in patients with early diabetic nephropathy (EDN) and the effect of pioglitazone on the expression of inflammatory factors and renal protective mechanism.Methods:A retrospective case-control study was conducted.From January 2019 to December 2019, the patients were divided into pioglitazone group ( n=35) and glimepiride group ( n=34). At the same time, 30 healthy people in the physical examination center of our hospital were selected as the control group.The levels of serum NF-κB and MCP-1 were detected by immunohistochemistry.The changes of fasting glucose, Hemoglobin A1C (HbA1c), renal function, urinary albumin excretion rate (UAER), and hypersensitive C-reactive protein(hsCRP), interleukin-6(IL-6), homeostasis model insulin Resistance index (HOMA-IR) were detected and compared among the three groups before treatment, pioglitazone group and glimepiride treatment group after treatment.To observe the effect of pioglitazone on serum NF-kB and MCP-1 expression in patients with early type 2 diabetic nephropathy. Results:Serum NF-κB, MCP-1, UAER, fasting blood glucose, HbA1c, HOMA-IR, hsCRP, IL-6 were significantly higher in the diabetic nephropathy group than those in the control group before treatment ( t values were 9.16, 7.61, 16.99, 17.01, 17.05, 12.01, 8.69, 6.28, all P<0.01). After 12 weeks of treatment, the levels of NF- κB, MCP-1, HOMA-IR, hsCRP, IL-6 and UAER in pioglitazone group were lower than those in glimepiide group ( t values were -5.03, -4.63, -2.35, -8.03, -3.06, -2.10, P<0.05 or P<0.01). After treatment, there were no statistically significant differences in fasting blood glucose and HbA1c between the pioglitazone group and the glimepiide group (all P>0.05). Serum NF-κB, MCP-1, HbA1c, HOMA-IR and UAER in EDN group were significantly positively correlated ( R values were 0.568, 0.532, 0.521, 0.466, all P<0.05). Conclusion:The expression of NF - κ B and MCP-1 in serum of EDN patients was increased, which indicated that there was chronic inflammation in patients.Pioglitazone could down regulate the expression of NF - κ B and MCP-1, so as to play an anti-inflammatory and renal protective role.
ABSTRACT
Objective To investigate the impact of severity of psoriasis on quality of life in patients with psoriasis vulgaris.Methods A questionnaire interview was carried out to the outpatients with psoriasis vulgaris(n=504)from Dec.2000to Sept.2001.All the patients were more than18years old.The content of questionnaire included daily life and activities,work and school performance,social activities and personal relationships,and psychologic status.Disease severity was assessed with psoriasis area and severity index(PASI).498patients were included for the final analysis.Statistical analysis was performed with SPSS software package.Results63.3%patients were restricted in their food selection.40.2%had bad sleep,59.0%could not dress short clothes in the summer.26.5%were restricted in use of public traffic and services.15.1%were rejected in haircut and cosmetic service.31.2%had decreased income along with severity of the disease.58.8%felt uncomfortable in social activities and public places.25.8%avoided handshaking with others.43.3%were reluctant in social intercourse.29.0%were not willing to take part in social activities,especially for moderate and severe cases.54.9%felt that their self-esteem was injured.26.6%thought that other peoples always avoided to meet them.64.4%felt anxiety for their disease.83.1%often worried about relapse or exacerbation of psoriasis.15.9%showed a tendency to commit suicide.Conclusions The more severe the disease is the more impact it may have on the daily life,work and school performance,social activities and personal relationship,and psychologic status in patients with psoriasis vulgaris.It is reccommended that besides the conventional treatment bio-psychic and social medical management be given to the patients especially for moderate and severe cases.