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Objective To investigate the cardiac structural and functional characteristics in the patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM),and predict the factors influencing the characteristics. Methods A total of 783 HFpEF patients diagnosed in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from April 2009 to December 2020 were enrolled in this study.Echocardiography and tissue Doppler technique were employed to evaluate cardiac structure and function.According to the occurrence of T2DM,the patients were assigned into a HFpEF+T2DM group (n=332) and a HFpEF group (n=451).Propensity score matching (PSM)(in a 1∶1 ratio) was adopted to minimize confounding effect.According to urinary albumin excretion rate (UAER),the HFpEF+T2DM group was further divided into three subgroups with UAER<20 μg/min,of 20-200 μg/min,and>200 μg/min,respectively.The comorbidities,symptoms and signs,and cardiac structure and function were compared among the groups to clarify the features of diabetes related HFpEF.Multivariate linear regression was conducted to probe the relationship of systolic blood pressure,blood glucose,glycosylated hemoglobin,and UARE with cardiac structural and functional impairment. Results The HFpEF+T2DM group had higher prevalence of hypertension (P=0.001) and coronary heart disease (P=0.036),younger age (P=0.020),and larger body mass index (P=0.005) than the HFpEF group,with the median diabetic course of 10 (3,17) years.After PSM,the prevalence of hypertension and coronary heart disease,body mass index,and age had no significant differences between the two groups(all P>0.05).In addition,the HFpEF+T2DM group had higher interventricular septal thickness (P=0.015),left ventricular posterior wall thickness (P=0.040),and left ventricular mass (P=0.012) and lower early diastole velocity of mitral annular septum (P=0.030) and lateral wall (P=0.011) than the HFpEF group.Compared with the HFpEF group,the HFpEF+T2DM group showed increased ratio of early diastolic mitral filling velocity to early diastolic mitral annular velocity (E/e') (P=0.036).Glycosylated hemoglobin was correlated with left ventricular mass (P=0.011),and the natural logarithm of UAER with interventricular septal thickness (P=0.004),left ventricular posterior wall thickness (P=0.006),left ventricular mass (P<0.001),and E/e' ratio (P=0.049). Conclusion The patients with both T2DM and HFpEF have thicker left ventricular wall,larger left ventricular mass,more advanced left ventricular remodeling,severer impaired left ventricular diastolic function,and higher left ventricular filling pressure than the HFpEF patients without T2DM.Elevated blood glucose and diabetic microvascular diseases might play a role in the development of the detrimental structural and functional changes of the heart.
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Humans , Aged , Heart Failure/diagnosis , Diabetes Mellitus, Type 2 , Stroke Volume , Glycated Hemoglobin , Blood Glucose , Propensity Score , Ventricular Function, Left , HypertensionABSTRACT
Objective To investigate the expression and clinical significance of vasohibin-1 (VASH-1) in patients with type 2 diabetes mellitus.Methods From November 2015 to December 2017,four hundred and twenty-two patients with T2DM in Chaoyang Central Hospital were selected and divided into three groups according to the urinary albumin excretion rate (UACR):normal albuminuria group (UACR ＜30 mg/g,149 cases),microalbuminuria group (30 ≤ UACR ≤ 300 mg/g,143 cases),clinical albuminuria group(UACR＞300 mg/g,130 cases).Three hundred healthy subjects in Chaoyang Central Hospital during the same period were selected as control group.The levels of serum VASH-1 and transforming growth factor-β1 (TGF-β1) in each group were determined by enzyme linked immunosorbent assay.Results VASH-1 and TGF-β1 in diabetic group and control group were (579±236) ng/L,(350±141) ng/L and (18.92 ±2.21) μg/L,(5.69 ± 0.70) μg/L,respectively.There were significant differences between the two groups (t =4.721,6.142,P＜0.01).The serum VASH-1 levels in normal albuminuria group,microalbuminuria group and massive albuminuria group were (450+182) ng/L,(571±194) ng/L,(786±201) ng/L,and the serum TGF-β1 levels were (11.71 ± 1.81) μg/L,(14.02 ± 2.91) μg/L,(19.32 ± 1.97) μg/L,respectively.Compared with the normal albuminuria group,the serum VASH-1 and TGF-β1 levels in the microalbuminuria group and the massive albuminuria group were significantly higher (P＜0.05),and the serum VASH-1 and TGF-β1 levels in the massive albuminuria group were significantly higher than those in the microalbuminuria group,with significant difference between the two groups (P＜0.05).Multivariate linear regression analysis showed that serum VASH-1 level was positively correlated with TGF-β1 in diabetic patients (r=0.554,P=0.000).Conclusion With the progress of DN microangiopathy,the serum VASH-1 concentration in type 2 diabetes mellitus increased significantly through negative feedback to regulate and control the formation of neovascularization and delay renal interstitial fibrosis,so as to achieve the protection of the kidney.
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Objective To observe the effect of the method of warming kidney and dredging collaterals on the clinical effect and the content of urine C5b-9 in patients with idiopathic membranous nephropathy with spleen kidney yang deficiency and blood stasis. Methods A total of 60 idiopathic membranous nephropathy patients with spleen kidney yang deficiency and blood stasis type were randomly divided into the conventional western medicine treatment group (control group), Jingui-Shenqi pill and Taohong-Siwu decoction plus conventional western medicine treatment group (treatment group), 30 cases in each group. The Scr was detected by deproteinized alkaline picric acid method, and BUN was detected by rate method, and serum albumin (ALb) was detected by bromocresol green dye binding method, and 24 hours urinary protein was measured by pyrogallol red colorimetry, and the double antibody sandwich ELISA method was used for detection of urinary C5b-9. Results The Jingui-Shenqi pill combined with Taohong-Siwu decoction plus conventional western medicine treatment has obvious curative effect on patients. The total effective rate was 83.3 in the treatment group (25/30), and the control group was 60％ (18/30). After treatment, the Alb (33.5 ± 7.95 g/L vs. 28.8 ± 6.10 g/L, t=2.569) in the treatment groupwas significantly higher than that in the conventional treatment group (P<0.01). While the 24 h urine protein (2.40 ± 0.92 g/24 h vs.3.60 ± 2.3 g/24 h, t=2.653), the contents of C5b-9 in urine(42.5 ± 17.50 ng/mg vs.71 ± 25.2 ng/mg, t=5.088) in the treatment group were significantly lower than those in the conventional treatment group (P<0.01). Conclusions The method of warming kidney and dredging collaterals can improve the clinical symptoms, improve serum albumin level, reduce the 24 hour urine protein and urinary C5b-9 content of idiopathic membranous nephropathy of spleen and kidney yang deficiency and blood stasis type.
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Objective To study the expression and clinical significance of serum 1,25-dihydroxyvitamin D3 in different stages of diabetic nephropathy patients.Methods Ninety-eight cases of diabetics were selected as our subjects in observation group,who were hospitalized in Tieying Hospital of Fengtai District of Beijing from January 2010 to December 2014.They were divided into diabetics group(36 cases,UAER ＜30 mg/24 h),microalbuminuria group(32 cases,UAER was 30-300 mg/24 h),massive proteinuria group (30cases,UAER＞300 mg/24 h).One hundred healthy persons were selected as a normal control group over the same period.The changes of fasting blood glucose,course of disease,blood lipid,serum creatinine and serum 1,25-dihydroxyvitamin D3 in all groups were recorded.Results Fasting blood glucose,serum creatinine and serum 1,25-dihydroxyvitamin D3 were (8.97±2.3) mmol/L,(76.2±19.5) μmol/L,(28.9±13.6) μg/L in observation group,and (4.7±0.4) mmol/L,(63.1±12.0) μmol/L,(70.1±21.3) μg/L in control group respectively,the difference between the two group was statistically significant (P =0.031,0.046,0.028).Serum 1,25-dihydroxyvitamin D3 was (52.68±20.91) μg/L in patients of diabetics group,(31.40±15.23) μg/L in microabuminuria group,(15.76±7.81) μg/L in massive proteinuria group,the difference among the three group was statistically significant (P =0.036).Serum 1,25-dihydroxyvitamin D3 of microabuminuria group and massive proteinuria group were lower than of diabetics group,of massive proteinuria group was lower than of microabuminuria group(P＜0.05).Serum 1,25-dihydroxyvitamin D3 was negatively correlated with the cause of disease(r=-0.301),fasting blood glucose (r =-0.281) and serum creatinine (r =-0.536) in patients with type 2 diabetes,the difference was statistically significant (P ＜ 0.05).Conclusion Serum 1,25-dihydroxyvitamin D3 in patients with diabetic nephropathy decrease in different degree,which reflects the severity of renal damage.The results indicate that reduction of serum 1,25-dihydroxyvitamin D3 may be involved in the occurrence and development of diabetic nephropathy
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Objective To investigate the expression and clinical significance of serum microRNA (miRNA) expression profiling in the occurrence and progression of diabetic nephropathy.Methods The miRNA expression profiling was detected by miRNA TaqMan Low Density Array chip from 10 patient with diabetic nephropathy,10 diabetes patients with normoalbuminuria and 10 health control.Real-time quantitative PCR was applied to verify the result of miRNA array in serum samples of 66 patients with diabetic nephropathy (36 patients with microalbuminuria,30 patients with macroalbuminuria),40 diabetes patients with normoalbuminuria and 40 health control.And the relationship of differetial expression with clinical features was analyzed.Results miR-150-5p,miR-155-5p,miR-30e-5p and miR-3196 being validated by real-time quantitative PCR differentially expressed in 3 groups of serum samples from the diabetes patients with microalbuminuria (n=36),with normoalbuminuria (n=40) and health control (n=40) (P ＜ 0.05).Serum miR-150-5p (P=0.005) and miR-155-5p (P=0.006) changed significantly between diabetes patients with microalbuminuria (n=36) and with macroalbuminuria (n=30).Compared with the diabetes patients with microalbuminuria,serum miR-150-5p and miR-155-5p increased by 2.3 and 1.5 times in macroalbuminuria group,respectively.Estimated glomerular filtration rate and urinary albumin excretion rate significantly correlated with serum miR-150-5p and miR-155-5p level.Conclusions miR-150-5p and miR-155-5p may be involved in the process of pathological mechanisms of diabetic nephropathy.Serum miR-150-5p and miR-155-5p may be regarded as potential biomarkers to diagnosis the occurrence and development of diabetic nephropathy.
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Objective To analyse the clinical significance of serum homocysteine(Hcy) and neutrophil gelatinase‐associated li‐pocalin(NGAL) in patients with hypertensive nephropathy ,and explore the relationship between serum homocysteine ,NGAL con‐centration and Urinary albumin excretion rate(UAER) .Methods 103 patients with hypertension treated in renal and cardiovascular department of Huangshi Central Hospital from January 2012 to June 2014 were enrolled in the study and were divided into 3 groups :macroalbuminuria group (36 cases) ,microalbuminuria group (35 cases) and negative albuminuria group (32 cases) .In addi‐tion to that ,33 healthy people were recruited as control group .Serum homocysteine ,NGAL concentration and UAER were meas‐ured for the peple enrolled in the study .Results Serum homocysteine and NGAL concentration of macroalbuminuria group and mi‐croalbuminuria group were much higher than negative albuminuria group and control group(P0 .05) .UAER was positively correlated with serum homocysteine and NGAL concentration(r=0 .792 ,0 .658 ,P<0 .05) . Conclusion The detection of serum homocysteine and NGAL are helpful in understanding the changes of disease in patients with hypertensive nephropathy .
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Objective:To observe the influence of valsartan combined with Bailing capsules on urinary albumin excretion rate in early stage of type 2 diabetic nephropathy ( DN) , and explore its protection in early DN. Methods:Sixty patients with early DN were randomly divided into two groups. On the basis of diet control and blood glucose regulation, the control group (n=30) was given valsartan 160 mg, qd, while the prevention group (n=30) was treated by valsartan (160 mg·d-1) combined with Bailing capsules (2. 0g, po, tid), and the treatment course was 12 weeks. The urinary albumin excretion rate ( UAER) , mean arterial blood pressure ( MAP) , serum creat-inine ( Scr) and hemoglobin A1c ( HbA1c) were measured and compared before and after the treatment in the two groups. Results:UAER in the two groups was significantly reduced after the treatment compared with that before the treatment (P0. 05). Conclusion:Valsartan combined with Bailing capsules shows certain effects in the treatment of early stage of type 2 diabetic nephropathy by decreasing the urinary albumin excretion.
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Objective To investigate the Effects of thyroxine on the level of serum homocysteine and urinary albumin excretion rate in elderly patients with early diabetic nephropathy and subclinical hypothyroidism.Methods Seventy-five patients with early diabetic nephropathy and subclinical hypothyroidism were randomly divided into levothyroxine treatment group and conventional treatment group.Urinary albumin excretion rate (UAER),serum levels of homocysteine,creatinine,and lipids were measured at both pre-and post-treatment of 48 weeks.Results After treatment,serum total cholesterol,low density lipoprotein-cholesterol,triglyceride,thyrotropin,homocysteine,UAER,and serum creatinine in the levothyroxine treatment group were significantly lower than those in the conventional treatment group [(-0.52 ± 0.12 vs 0.31 ± 0.40) mmol/L,(-0.33 ± 0.22 vs 0.24 ± 0.36) mmol/L,(-0.16±0.18 vs0.19±0.29)mmol/L,(-4.4 ± 1.2 vs 1.2 ±0.8)mIU/L,(-1.4 ±2.0 vs0.9± 1.0)mmol/L,(-13 ± 13 vs 10 ± 7) pg/ml,(-2 ± 2 vs 3 ± 2) μmoL/L,respectively,all P＜0.01].Conclusions Treatment with levothyroxine could significantly improve serum lipid profiles and reduce homocysteine,UAER,and creatinine,and exert a protective effect on the kidney in the elderly patients with early diabetic nephropathy and subclinical hypothyroidism.
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This study was aimed to observe the effect of Danzhi Jiangtang Capsule ( DJC ) on NF-κB in the peripheral blood mononuclear cell , and inflammation indices such as serum MCP-1 , TGF-β1 and urinary albu-min excretion rate ( UAER ) in early diabetic nephropathy ( EDN ) , in order to discuss the possible mechanism of DJC on anti-inflammatory and renal protection effect of EDN. A total of 72 EDN patients which met the in-clusion criteria after the start-up stage were taken as research objects . They were randomly divided into the control group and the treatment group. The western comprehensive treatment plan was given to both groups. In the treatment group, DJC was added. And the treatment course was 8 weeks. Changes of MCP-1, NF-κB, TGF-β1 and UAER were observed before and after the treatment . The results showed that MCP-1 , NF-κB and TGF-β1 had significant positive correlation with UAER ( P ment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER in the control group and treatment group after treat-ment were significantly declined ( P < 0 . 05 ) . Compared with the control group , after treatment , the levels of MCP-1 , NF-κB , TGF-β1 and UAER of the treatment group were obviously reduced ( P < 0 . 05 , or P <0 . 01 ) . It was concluded that DJC can reduce the UAER , delay the renal injury , and downregulate levels of MCP-1, NF-κB and TGF-β1, block the expression of inflammatory mediators, inhibit inflammatory reaction and improve microinflammatory state of EDN. This may be one of the important mechanisms in the protection of renal function .
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Objective To investigate the type 2 diabetic patients with glomerular filtration rate and urinary albumin value as renal finction evaluation.Methods A total of 1217 patients with type 2 diabetic nephropathy from August 1,2010 to June 31,2012 were selected.Evaluated glomerular filtration rate (eGFR) was calculated according to the currently recommended simplified modification of diet in renal disease study (MDRD) formula.According to the K/DOQI guidelines for chronic kidney disease,patients were divided into three groups:group A [eGFR ≥90 ml/ (min ·1.73 m2)] of 891 cases,group B [60 ml/(min· 1.73 m2) ≤eGFR ＜ 90 ml/(min· 1.73 m2)] of 256 cases,group C[eGFR ＜ 60 ml/(min· 1.73 m2)]of 70 cases,respectively.Eight-hour urinary albumin excretion rate (UAER) was compared between and among the groups; according to 8-hour UAER,patients were divided into three groups:group a (8-hour UAER ＜20 μg/min) of 946 cases,group b (20 μg/min≤8-hour UAER ＜200 μg/min) of 193 cases,group c(8-hour UAER ≥ 200 μ g/min) of 78 cases.eGFR was calculated and compared between and among the groups.Results Eight-hour UAER was (32.71 + 79.62),(57.56 + 130.59),(107.50 + 222.64) μ g/min in group A,B,C,and the difference among three groups was statistically significant (P＜0.05).eGFR was (110.78 ±32.75),(108.26 ±45.78),(94.96 ±32.30) ml/ (min ·1.73 m2) in group a,b,c,and the difference between group a and group c,or between group b and group c was statistically significant (P ＜0.05),but the difference between group a and group b was not statistically significant (P ＞0.05).Conclusion When evaluating the function of type 2 diabetic nephropathy,two indicators should be considered:glomerular filtration rate and urinary albumin.
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Context : To evaluate the usefulness of urinary albumin excretion rate (UAER) i.e. Albumin/Creatinine Ratio (ACR) in diagnosis and prognosis of essential hypertension (EHT). Objectives : To find out the association of urinary albumin excretion rate with the pathophysiology of essential hypertension. Study Design : A cross-sectional analytical study. Materials & Methods : Urinary albumin excretion (UAE), urinary creatinine (UC) and UAER were analyzed and compared between hypertensive cases and age & sex matched normotensive controls of age group 30-65 years using unpaired two-tailed Student ‘t’ test. All statistical analyses were done with PASW (SPSS) v.18.0. Results : Systolic BP (SBP) and diastolic BP (DBP) of cases were found to be significantly higher (p < 0.001) than controls. Urine MAlb level (p < 0.001) and ACR (p < 0.001) in cases were significantly higher compared to controls. Correlation studies showed that SBP and DBP was significantly positively correlated with urine MAlb (SBP: r = 0.859, DBP: r = 0.733; p < 0.001) and ACR (SBP: r = 0.830, DBP: r = 0.739; p < 0.001). Sex-wise comparison in cases revealed that males had statistically non-significant (p > 0.05) lower levels of urine MAlb as compared to females but had significantly higher (p < 0.001) levels of urine creatinine and lower (p < 0.001) ACR compared to females. Conclusion: Urinary MAlb levels and ACR are seen to be increased in hypertensive subjects compared to normotensive subjects. ACR was significantly higher in female hypertensives than males which can be credited to the physiologically observed lower urine creatinine levels compared to males. Both Microalbuminuria and ACR can serve as specific and well-established marker of cardiovascular and renal damage in EHT.
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Adult , Albumins/diagnosis , Albumins/metabolism , Creatinine/metabolism , Creatinine/urine , Female , Humans , Hypertension/diagnosis , Hypertension/urine , Male , Middle Aged , Prognosis , Renal EliminationABSTRACT
ObjectiveTo investigate the correlation between the level of resistin and the insulin resistance(IR) and the incorporation of microamount albuminuria(MA) of type 2 diabetes mellitus (T2DM).MethodsTwo hundred and twenty T2DM patients and 40 normal subjects (control group) were enrolled in this study.Two hundred and twenty T2DM patients were divided into 4 groups,IR group (group A,79 cases),non-IR group (group B,48 cases),IR complicating MA group (group C,51 cases),non-IR complicating MA group(group D,42 cases).The fasting serum resistin was measured by enzyme-linked immunosorbant assay (ELISA),and the fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS) was also determined.ResultsThe level of fasting serum resistin in group A,B,C and D was higher than that in control group [(33.45 ± 1.37),(23.36 ± 1.47),(44.45 ± 1.39),(37.45 ±1.57) μ g/L vs.( 17.44 ± 1.26 ) μ g/L],and there was significant difference among 5 groups (P ＜ 0.01 ).The level of fasting serum resistin in group A was higher than that in group B (P ＜ 0.01 ),and the level of fasting serum resistin in group C was higher than that in group D (P ＜ 0.01 ).The level of fasting serum resistin was both higher in group C and D than that in goup A and B (P＜ 0.01 ).Correlation analysis showed the fasting serum resistin was positively correlated with body mass index(BMI),FPG,HbA1c and FINS in group A(r =0.35,0.46,0.37,0.49,P ＜0.05),and the fasting serum resistin was positively correlated with HbA1c,BMI,systolic blood pressure and diastolic blood pressure in group C(r =0.45,0.32,0.37,0.29,P ＜ 0.05 ).ConclusionsSerum resistin may participate in the process of IR and the formation of MA.It may become one of the diagnostic standard of the IR and one of the important index to estimate the MA.
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Objective To compare the effects of fluvastatin and valsartan on the inflammatory cytokines in the early stage of type 2 diabetic nephropathy and their protective effects on to diabetic nephropathy. Methods Ninety patients with early stage of type 2 diabetic nephropathy were divided into three groups, 30 patients receiving routine hypoglycemic agents (DN1) as control,30 patients receiving routine hypoglycemic agents plus valsartan (DN2) and the other 30 receiving routine hypoglycemic agents plus fluvastatin (DN3). Blood glucose, blood lipid,serum creatinine and C reactive protein(CRP),24-hour urine protein,urinary albumin excretion rate (UAER) and several inflammatory cytokine were measured before and after treatment. Results ( 1 ) No significant difference of the levels of serum CRP,TGF-β1,IL-6,TNF-α, IL-18 at the baseline were observedamong these three groups.In the DN2 group,after treatment,IL.6 was([15.99±2.87]ng/L and[17.64±2. 131 ,P 0. 05). (2) In the subgroup that there was no difference in blood pressure between before and after treatment in both the DN2 and DN3 group,in the DN3 group,UAER was ([63. 1 ±31.7] μg/min and[82.9±40.0] μg/min,t = -2. 145,P 0. 05 ). Conclusion Both valsartan and fluvastatin are able to protect the renal function of patients with type 2 diabetic nephropathy by decreasing the levels of urine proteins and correlated serum inflammatory cytokines.
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Objective To observe the influence of Shenkang injection with Irbesartan on urinary albumin excretion rate(UAER)in 24 hours,serum lipid and blood rheology in early diabetic nephropathy.Methods One hundred and fifty normotensive early diabetic nephmpathy were randomly divided into control group,Shenkang injection group and Shenkang injection with Irbesartan group.Three groups were treated with diabetic education,dietary regimen,suitable physical activity and oral anti-hyperglycemic agents till their fasting blood glucose(FBG)was less than 7.0 mmol/L and postprandial blood glucose(PBG)was less than 10.0 mmol/L.The control group was treated with oral anti-hyperglycemic agents or/and insulin.Shenkang injection group was additionally treated with Shenkang solution.Shenkang solution was mixed by Shenkang injection 100 ml,5% glucose 250 ml and insulin 2-3 U.Shenkang solution was intravenously guttaed once a day.Shenkang injection with Irbesartan group was additionally treated with Irbesartan 0.15 g,once a day,taken orally.A course was taken for 3 weeks.The levels of UAER,serum lipid and blood rheology were detected immediately and 9 weeks after treatment.Results In the Shenkang injection group,compared with those before treatment,them were significant difference in UAER (87.44 ±10.06)μg/min vs.(116.55 ± 33.42)μg/min),serum lipid( (4.22 ± 0.70)mmol/L vs.(4.88 ± 0.69 )mmol/L)and blood rheology( (5.77 ±0.53)mPa·s vs.(7.38 ± 0.41)mPa·s)(P ＜ 0.05).In the Shenkang injection with Irbesartan group,compared to those before treatment,there were also significant difference in UAER ( (61.90 ±28.02)μg/min vs.(123.37 ± 29.98)μg/min),serum lipid( (4.00 ± 0.14)mmol/L vs.(4.90 ± 0.12)mmol/L)and blood rheology( (5.11 ±0.41)mPa·s vs.(7.27 ± 0.44)mpa·s)(P ＜ 0.05).Whearas in the control group,no significant difference were found compared with those before treatment.Furthermore,the improvements in the Shenkang injection with Irbesartan group were better than those in the Shenkang injection group(P ＜ 0.05).Conclusions Shenkang injection can reduce UAER,decrease serum lipid and improve renal blood rheology.Iteffectively prevents diabetic nephropathy in earlier period and maybe have synergy with Irbesartan.
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Objective To investigate the relationship between serum uric acid ( SUA) concentration and urinary albumin excretion rate ( UAER) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitua (T2DM). Methods The clinical data of 372 patients with T2DM. including 184 males and 188 females, were collected. The correlations between SUA and the other clinical indexes were analysed by Pearson method, and multiple regression analysis was employed to examine the effects of various factors on UAER and CIMT. Results SUA concentration was higher in males than in females with T2DM (P <0. 01). and was positively correlated with UAER both in males and females with T2DM, even after adjustment for the creatinine clearance (r = 0.24, P < 0.01 for males; r = 0. 29, P < 0.01 for females). Positive correlation was found between SUA concentration and CIMT in females (r =0. 29, P < 0. 01). Multiple regression analysis demonstrated that SUA concentration was an independent determinant of UAER for males as well as females (β=0.16, P<0.05 for males; β=0. 20, P < 0. 05 for females), and was also an independent determinant of CIMT for females (β =0.16, P <0.05). Conclusion SUA plays an important role in the progression of diabetic nephropathy and cardiovascular diseases in patients with T2DM. SUA control may provide a novel approach for the treatment of diabetic nephropathy and vascular complications.
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Objective To observe the effect of fluvastatin on urinary albumin excretion rate(UAER)of microalbuminuria in type 2 diabetes patients.Methods Type 2 diabetes patients with mieroalbuminuria were randomly divided into fluvastatin goup(n=126)and control group(n=129).Fluvastatin group was given fluvastatin 40 mg each night.Follow up was conducted for 1.5 years.The UAER and glomerular filtration rate(GFR)as well as blood lipid level before and after therapy were compared.Results UAER in fluvastatin group was significantly lower than that in control group[(59.6±10.5)vs(87.5±12.3)mg/min,P＜0.05]before therapy[(104.4±25.2)vs(110.6±19.7)mg/min,P＜0.05],which was independent of its lowering-lipid effect.But GFR had no signifimicroalbuminuria which is independent of lowering-lipid effect in type 2 diabetic nephropathy patients and delay the progress of diabetic nephropathy.
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Objective To study the changes of mean platelet volume and urinary albumin excretion rate and retinal thickness and relationship among them in diabetes mellitus patients with retinopathy(DR).Methods Mean platelet volume was measured with MEK-6318K automated blood cell counter;retinal thickness was measured with optical coherence tomography(OCT);urinary albumin excretion rate was measured with rate nephelometry in DR,which were compared with those of 30 normal controls.Results The mean platelet volume and retinal thickness and urinary albumin excretion rate in DR were significantly higher than those in normal controls(P
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0.05],but significant difference existed in children with HSPN compared with HSP and control group[(3.01?1.52) g/d vs (0.05?0.02) g/d or (0.04?0.02) g/d Pa
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Diabetes is a rapidly increasing heath care problem all over the world due to increased prevalence during past decade. Diabetic nephropathy develops in 25-30% of patients with type 1 diabetes and is the leading cause of end stage renal disease. Diabetic nephropathy is characterized by persistent proteinuria, decline in renal function, hypertension and increased cardiovascular morbidity and mortality. Early detection of diabetic nephropathy risk is an important goal because early diagnosis and treatment prevent advanced renal damage and other diabetic complications. Increased urinary albumin excretion rate is widely accepted as the first clinical sign of diabetic nephropathy. However, reduced glomerular filtration or hypertension could be the first manifestation in some diabetic patients. We need improved markers and predictors of diabetic nephropathy risk. We report a case of diabetic nephropathy and decreased glomerular filtration rate (GFR) without microalbuminuria occcured in type 1 diabetic patient.
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Humans , Diabetes Complications , Diabetic Nephropathies , Early Diagnosis , Filtration , Glomerular Filtration Rate , Hypertension , Kidney Failure, Chronic , Mortality , Prevalence , ProteinuriaABSTRACT
Objective To investigate the changes of bone mineral density (BMD) and its causing factors in menopausal female patients with type Ⅱ diabetes mellitus (DM2). Methods Dual energy X ray absorptimetry was used to measure the BMD of lumbar spines (L 2-4 ) and proximal femur in 82 female patients with type Ⅱ diabetes and 46 normal controls. According to BMD, DM2 patients were divided into two groups (DM A and DM B). Fasting plasma glucose (FPG), fasting plasma insulin (FINS), fasting plasma C peptide (FCP), glycated hemoglobin (HbAc1), urine albumin excretion rate (UAER), and urine ? 2 microglobin (? 2 MG) were measured and compared between the two groups. Results BMD of lumbar spines (L 2-4 ), femoral neck and Ward's triangle in diabetic patients were significantly lower than that of the controls ( P