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This study explored the prescription and medication rules of traditional Chinese medicine(TCM) in the prevention and treatment of diabetic microangiopathy based on literature mining. Relevant literature on TCM against diabetic microangiopathy was searched and prescriptions were collected. Microsoft Excel 2021 software was used to establish a prescription database, and an analysis was conducted on the frequency, properties, flavors, meridian tropism, and efficacy classifications of drugs. Association rule analysis, cluster analysis, and factor analysis were performed using SPSS Modeler 18.0 and SPSS Statistics 26.0 software. The characteristic active components and mechanisms of action of medium-high frequency drugs in the analysis of medication rules were explored through li-terature mining. A total of 1 327 prescriptions were included in this study, involving 411 drugs, with a total frequency reaching 19 154 times. The top five high-frequency drugs were Astragali Radix, Angelicae Sinensis Radix, Poria, Salviae Miltiorrhizae Radix et Rhizoma, and Rehmanniae Radix. The cold and warm drugs were used in combination. Drugs were mainly sweet, followed by bitter and pungent, and acted on the liver meridian. The majority of drugs were effective in tonifying deficiency, clearing heat, activating blood, and resolving stasis. Association rule analysis identified the highly supported drug pair of Astragali Radix-Angelicae Sinensis Radix and the highly confident drug combination of Poria-Alismatis Rhizoma-Corni Fructus. The strongest correlation was found among Astragali Radix, Angelicae Sinensis Radix, Poria, and Salviae Miltiorrhizae Radix et Rhizoma through the complex network analysis. Cluster analysis identified nine categories of drug combinations, while factor analysis identified 16 common factors. The analysis of active components in high-frequency drugs for the treatment of diabetic microangiopathy revealed that these effective components mainly exerted their effects by inhibiting oxidative stress and suppressing inflammatory reactions. The study found that the pathogenesis of diabetic microangiopathy was primarily characterized by deficiency in origin, with a combination of deficiency and excess. Deficiency was manifested as Qi deficiency and blood deficiency, while excess as phlegm-heat and blood stasis. The key organ involved in the pathological changes was the liver. The treatment mainly focused on supplementing Qi and nourishing blood, supplemented by clearing heat, coo-ling blood, activating blood, and dredging collaterals. Commonly used formulas included Danggui Buxue Decoction, Liuwei Dihuang Pills, Erzhi Pills, and Buyang Huanwu Decoction. The mechanisms of action of high-frequency drugs in the treatment of diabetic microangiopathy were often related to the inhibition of oxidative stress and suppression of inflammatory reactions. These findings can provide references for the clinical treatment of diabetic microangiopathy and the development of targeted drugs.
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Humans , Medicine, Chinese Traditional , Drugs, Chinese Herbal/therapeutic use , Prescriptions , Drug Combinations , Diabetic Angiopathies/drug therapy , Data Mining , Diabetes Mellitus/drug therapyABSTRACT
Pigment epithelium-derived factor (PEDF ) was originally found fromretinal pigment epithelium. It is confirmed that it plays an anti-angiogenic and apoptosis role in diabetic microangiopathy. Recently ,PEDF has been found to have a close relationship with insulin resistance ,type 2 diabetes and diabetic macroangiopathy. But the mechanism is unclear. More and more researches focused on its role in oxidative stress. PEDF may become a new target for diabetes and diabetic complication treatment and also a predictive factor for the disease.
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Objective To explore the relationship between platelet to lymphocyte ratio (PLR) and microangiopathyin type 2 diabetes mellitus. Methods In this case-control study, the clinical data on 428 adult patients with type 2 diabetic microangiopathy in our hospital from January 2009 to December 2015 were retrospectively analyzed. PLR, age, sex, fasting blood glucose, glycosylated hemoglobin, total cholesterol and triglyceride were tested to investigate their relationship with type 2 diabetic microangiopathy. Results Logistic regression analysis showed that PLR was a risk factor of type 2 diabetic microangiopathy (OR = 3.162, 95%CI:1.556 ~ 7.421, P < 0.05). Conclusions Greater PLR is closely related to type 2 diabetic microangiopathy, and we should pay attention to type 2 diabetic microangiopathy with a greater PLR in clinical practice.
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Objective To detect the serum thrombus precursor protein(TpP)level in the patients with diabetic microangiopathy and to investigate the relationship between the changes of TpP concentrations and the diabetic microangiopathy.Methods 136 ca-ses of diabetic microangiopathy in the endocrinology and neurology departments of our hospital from July to December 2013 were selected as the research subjects and 58 healthy individuals with physical examination were selected as the normal control group(NC group).The serum TpP,Fib,D-dimer concentrations and PT,APTT were measured.The SPSS14.0 software package was adopted to perform the statistical processing.Results (1).Serum TpP concentration in the diabetic microangiopathy group was significantly higher than that in the NC group with statistical difference(P 0.05).(2).According to whether or not complicating cerebral infarction,the diabetic microan-giopathy group was divided into two subgroups.and diabetic not merged cerebral infarction group.Serum TpP concentrations in the complicating cerebral infarction subgroup was significantly higher than that in the non-complicating cerebral infarction subgroup with statistical difference(P <0.05 ).Conclusion The serum TpP concentration in the diabetic microangiopathy is significantly higher than that in the control group,which indicating that the patient is in a hypercoagulable status the risk of thrombosis.The TpP detection may contribute to early diagnosis and timely treatment of thrombotic diseases for these patients.
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Background: Amadori-modified glycated plasma proteins play an important role in diabetic microangiopathy. Many of the pathogenic changes that occur in diabetic nephropathy (DN) may be induced by non-enzymatic glycation (NEG). Objective: The aim of this study was to determine prevalence of DN and non-enzymatic glycation levels in diabetic population. Methodology: One hundred patients with type 2 diabetes and forty healthy control subjects were recruited after consent. Case participants were further divided into two groups as type 2 diabetics with nephropathy (n = 22) and type 2 diabetics without nephropathy (n = 78). Non-fasting plasma glucose (Trinder GOD-PAP method), total plasma proteins (biuret method), Erythrocyte sedimentation rate (Westergren’s method), HbA1c (glycohemoglobin spectrophotometry A1c Kit) and non-enzymatic glycation (TBA colorimetric technique) were assayed. Results: Diabetic patients with nephropathy had higher ESR (55.33 ± 24.68 mm/1st hour vs. 46.88 ± 23.95 mm/1st hour vs.12.73 ± 2.34 mm/1st hour), total proteins (15.71 ± 4 g/dL vs.14.01 ± 4 g/dL vs 6.18 ± 1.16 g/dL) and non-enzymatic glycation (1.73 ± 0.48 mol./mol. vs.1.47 ± 0.58 mol./mol. vs. 0.48 ± 0.18 mol./mol.) measurements as compared to those without any similar renal complications and controls. Appreciable correlation existed between hyperglycemia and non-enzymatic glycation. Conclusion: Although the clinical consequences of NEG of circulating proteins remain ambiguous. In diabetic patients, however, extensively glycated species could exhibit significant alterations in function. Present study suggests DN as a frequently prevalent secondary complication of diabetes with a potential link with elevated NEG and glycemic control.
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OBJECTIVE: To investigate the association between type 2 diabetes mellitus and bone mineral density (BMD), the relationship between the duration of type 2 diabetes and BMD, and the effect of diabetic microangiopathies on BMD. METHOD: 52 men, aged 55~65 years, with type 2 diabetes and 52 men without diabetes were studied and matched by age and body mass index (BMI). The slit-lamp examinations and the nerve conduction studies were used for diagnosing diabetic retinopathies and diabetic peripheral polyneuropathies, respectively. The densitometric studies were carried out in the L1, L2, L3, L4 and total lumbar vertebra, the femoral necks, the trochanters, and total hips using a DEXA densitometer. RESULTS: Diabetic men had BMDs similar to those of the control group. There is no relationship between the duration of diabetes and BMD. BMDs at the trochanters in subjects with diabetic microangiopathies were reduced in comparison with those without diabetic microangiopathies (p<0.05). CONCLUSION: The densitometric studies may be helpful to diabetic men with microangiopathies, especially with other osteoporotic risks.
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Humans , Male , Body Mass Index , Bone Density , Diabetes Mellitus, Type 2 , Diabetic Angiopathies , Diabetic Retinopathy , Femur , Femur Neck , Hip , Neural Conduction , Polyneuropathies , SpineABSTRACT
Objective To explore the changes of serum leptin level in patients with diabetic microangiopathy.Methods A total of 90 subjects were assigned to three groups which included 30 healthy controls,30 diabetic patients without microangiopathy and 30 patients with diabetic microangiopathy.The studing groups were matched for sex and BMI.The level of serum leptin ,ⅣC,insulin and glucose of these patients were measured,and the correlation between serum leptin level and other indexes was analyzed.Results The level of serum leptin in controls,diabetic patients without microangiopathy and patients with diabetic microangiopathy were (7.20?2.11) ?g/L, (7.95?3.78)?g/L and (10.26?4.37)?g/L respectively .The patients with diabetic microangiopathy had higher serum leptin levels than in the diabetic patients without microangiopathy( t =2.18, P
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We investigated the effects of Kampo treatment on the development and progression of diabetic microangiopathy in 141 patients (95 male and 46 female patients, mean±S.D., 61.3±10.1 years) with non-insulin dependent diabetes mellitus. To this purpose, we examined the severity of diabetic microangiopathy with respect to the duration of suffering from diabetes mellitus as well as the duration of the condition after the commencement of Kampo treatment. We obtained the following results. 1) The significantly lighter the severity of diabetic nephropathy was, the longer its duration under Kampo treatment was. 2) In the group of shorter duration of suffering from diabetes mellitus, although there was no statistical significance, the longer the duration under Kampo treatment was, the lighter the severity of diabetic neuropathy and retinopathy was. But, there was no significant difference in the longer duration of suffering. It was suggested that the combination therapy with Kampo treatment was effective for diabetic microangiopathy.
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Nodular glomerulosclerosis was first described by Kimmelstiel and Wilson in 1936. Diabetic retinopathy and nephropath y are manifestation of the microangiopathy associated with diabetes. The severity of diabetic nephropathy and the occurrence of retinopathy correlate with the duration of clinical diabetes. However, there have been few reports of patients presents presenting with the classic lesions of diabetic microangiopathy in the absence of a known history of diabetes. These reports raise questions regarding the relationship and significance of carbohydrate intolerance to these pathologic abnormalities. A 34-year-old male patient clinically characterized by massive proteinuria and hypertension without evidence of systemic disease is reported. Renal biopsy showed the nodular glomerulosclerosis (Kimmelstiel-Wilson lesion) characteristic of diabetes. Direct opthalmoscopy and fluorescein angiography demonstrated a picture of advanced proliferative diabetic retinopathy. The patient had no history of diabetes mellitus and upon testing had normal glucose values in response to an oral glucose tolerance test. It is concluded that the nodular glomerulosclerosis lesions and proliferative retinopathy, thought to be specific for diabetes mellitus, may present in the absence of either overt clinical diabetes or impaired glucose tolerance.
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Adult , Humans , Male , Biopsy , Diabetes Mellitus , Diabetic Angiopathies , Diabetic Nephropathies , Diabetic Retinopathy , Fluorescein Angiography , Glucose , Glucose Tolerance Test , Hypertension , ProteinuriaABSTRACT
BACKGROUND: Several epidemiological studies have shown that high plasma concentration of lipoprotein(a) [Lp(a)] is associated with an increased risk for atherosclerotic cardiovascular disease and works as an independent risk factor for atherosclerosis. But, the significance of Lp(a) in diabetic microangiopathy & neuropathy is unclear essentially due to a paucity of relevant studies. This study was designed to evaluate whether Lp(a) concentration may be increased in patients with diabetic microangiopathy & neuropathy. METHODS:We studied 96 patients who visited the department of internal medicine in Pusan National University Hospital from May 1995 to May 1996. The patients were grouped according to the presence of diabetic complications(microangiopathy and neuropathy, microangiopathy included retinopathy and nephropathy) and therapeutic modalities(diet, insulin, insulin with oral hypoglycemic agent, and oral hypoglycemic agent). RESULTS: 1) Concentration of Lp(a) was significantly higher(p or = 50 mg/dl was significantly correlated with diabetic retinopathy & nephropathy, but was not significantly correlated with diabetic neuropathy. Duration of diabetes(> or =7 years) and total cholesterol(> or =240 mg/dl) were significantly correlated with diabetic retinopathy, nephropathy and neuropathy. CONCLUSIONS: Lp(a) concentration is increased in patients with diabetic microangiopathy and neuropathy compared with patients without these complications. So, Lp(a) may works as risk factor for diabetic microangiopathy and neuropathy, and further study to evaluate the role of Lp(a) as a risk factor of such complications would be necessary in large number of patients.
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Humans , Atherosclerosis , Cardiovascular Diseases , Diabetic Angiopathies , Diabetic Neuropathies , Diabetic Retinopathy , Epidemiologic Studies , Hypoglycemic Agents , Insulin , Internal Medicine , Lipoprotein(a) , Logistic Models , Plasma , Risk FactorsABSTRACT
In diabetes mellitus, thickening of basement membrane in capillaries and small vessels is a well-known finding and important in the progression of diabetic microangiopathy. We evaluated whether the plasma levels of type IV collagen and fibronectin, which are important factors of basement membrane, are related with the presence of diabetic microangiopathy. Plasma type IV collagen and fibronectin levels were measured in 40 healthy controls (Mean +/- SD, age; 50.3 +/- 5.5 yr) and 94 diabetic patients (age; 52.4 +/- 13.5 yr) with and without microvascular complications. The mean plasma levels of type IV collagen (5.3 +/- 2.9 ng/ml) and fibronectin (474.4 +/- 119.4 ug/ml) in diabetic patients were significantly higher (p < 0.01) than in healthy controls (3.7 +/- 1.3 ng/ml and 319 +/- 50.9 ug/ml). The mean plasma level of type IV collagen in diabetic patients with complications (6.6 +/- 3.7 ng/ml) was significantly higher (p < 0.01) than in those without complications (4.3 +/- 1.7 ng/ml) and became higher in more complicated patients. Furthermore, the severity of retinopathy and several indicators of nephropathy such as serum BUN, creatinine and proteinuria were closely associated with plasma type IV collagen level and a significant correlation was found between plasma type IV collagen and creatinine clearance (r = -0.31, p < 0.001). There was no significant difference in plasma fibronectin concentrations, however, between the diabetic patients with complications and those without complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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Adult , Aged , Female , Humans , Male , Biomarkers/blood , Blood Proteins/urine , Blood Urea Nitrogen , Collagen/blood , Creatinine/blood , Diabetic Angiopathies/blood , Diabetic Nephropathies/blood , Diabetic Retinopathy/blood , Fibronectins/blood , Middle AgedABSTRACT
To determine the early diagnostic parameters of the left ventricular diastolic filling defect in the uncontrolled adult onset diabetes mellitus, 86 diabetics were evaluated from the left ventricular inflow velocity pattern using pulsed Doppler echocardiography compared with normal 21 subjects. The diabetics were divided into 3 groups according to the presence or absence of background diabetic retinopathy(RE or coexisting cardiovascular diseases(group I : 34 cases without RE, group II : 24 cases with RE, group III : 28 cases with CVD). RE was thought to be having microangiopathy, but the cases with persistant massive proteinuria were excluded in this study. The left ventricular inflow velocity patterns were recorded from the apical approach. Peak velocity of the rapid filling phase(PFVE), that in the atrial systole(PFVA), E/A ratio, acceleration time(AT), deceleration time(DT), acceleration rate(ATR) and deceleration rate(DTR) were measured in the left ventricular inflow patterns. The results were ; 1) PFVE, AT and ATR in group I(56.26+/-12.21mm/sec, 70.91+/-14.98msec, 858.5+/-247mm/sec2), group II(51.91+/-14.35mm/sec, 64.84+/-14.98msec, 855.7+/-248.5mm/sec2) and group III(50.07+/-12.45mm/sec, 67.59+/-17.46msec, 817.5+/-266.8mm/sec2) were not significantly changed(p>0.05) compared to the controls(50.24+/-8.24mm/sec, 66.19+/-10.98msec, 784.5+/-221mm/sec2). 2) PFVA and DT in group I(51.21+/-14.86mm/sec, 156.2+/-23.42msec) and group II(64.26+/-13.93mm/sec, 64.84+/-14.13msec) were significantly increased(p0.05). 3) E/A ratio was significantly decreased in group II(0.82+/-0.21) and III(0.75+/-0.23) compared to the controls(1.19+/-0.25, p0.05) was noted. 4) DTR was also decreased in group II(311.9+/-95mm/sec2, p<0.05) and group III(297.7+/-125.8mm/sec2, p<0.05) compared to the controls(370.2+/-88mm/sec2) and group I(379.8+/-126mm/sec2). In conclusion, left ventricular diastolic filling defect in adult onset diabetics could be determined by using a various parameters of the pulsed Doppler echocardiography, which were closely related with diabetic retinopathy(RE). And DT and PFVA could be used as good parameters for early determination of the left ventricular diastolic filling defect in diabetics even without microangiopathy.
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Adult , Humans , Acceleration , Deceleration , Diabetes Mellitus , Diabetic Angiopathies , Echocardiography , Echocardiography, Doppler, Pulsed , ProteinuriaABSTRACT
Objective:To detect the distribution of the (C-106T) single nucleotide polymorphism and genotype of promoter region of aldose reductase gene and to study its relation to the susceptibility of microangiopathy in type 2 diabetes mellitus in Chinese Han from Chongqing.Methods:The aldose reductase gene in promoter region was amplified by polymerase chain reaction and the frequency of genotype of type 2 diabetes were analyzed by restriction enzyme BfaI.Results:The frequencies of genotype CC were significantly higher and the frequencies of genotype TT were much lower in type 2 diabetes patients with microangiopathy than in those without microangiopathy (? 2=6.78 and 4.45,respectively,P