ABSTRACT
Objective To investigate the association of adaptor protein,phosphotyrosine interacting with PH domain and leucine zipper 1(APPL1)with urinary albumin excretion rate in patients with type 2 diabetes mellitus (T2DM),and to explore the role of APPL1 in the development of diabetic kidney disease(DKD). Methods According to the urinary albumin/creatinine ratio(UACR),288 newly-diagnozed patients with T2DM were divided into normal albuminuria group(UACR<30 mg/g,n=116),microalbuminuria group(UACR 30 ~300 mg/g,n=95),and macroalbuminuria group(UACR>300 mg/g,n=77). 130 healthy subjects with matched sex and age were used as control group. Serum APPL1,tumor necrosis factor α(TNF-α),and adiponectin levels were measured by ELISA method. Results Serum APPL1 level in T2DM patients was significantly higher than that in control subjects (P<0.01), and increased with the rising of UACR. In patients with T2DM, serum APPL1 level was negatively correlated with estimated glomerular filtration rate(r=-0.246, P<0.01) while it was positively correlated with HbA1C, low density lipoprotein cholesterol, total cholesterol, triglycerides, insulin resistance index, serum creatinine,blood urea nitrogen, systolic blood pressure, TNF-α, and adiponectin(r=0. 119, 0. 167, 0. 209, 0.194,0.273,0.242,0.131,0.144,0.365, and 0.952, respectively, P<0.05 or P<0.01). Conclusion Serum APPL1 level in patients with T2DM was increased with the rising of UACR, suggesting that APPL1 may be involved in the development of DKD.
ABSTRACT
Objective To observe the relationship of liver ultrasound class and urinary albumin excretion ratio (UAER) in type 2 diabetes mellitus (T2DM) combined with nonalcoholic fatty liver disease (NAFLD). Methods One hundred and ninety-seven T2DM patients were divided into 3 groups according to the degree of hepar adiposum: group A (66 subjects without NAFLD), group B (63 subjects with mild NAFLD) and group C (68 subjects with moderate or severe NAFLD). Their clinical indexes,UAER and biochemical parameters were measured and compared, the relative analysis of blood fat, HOMA-IR and UAER was done. Results Compared with those in group A, the levels of UAER were significantly increased [(86.49 ± 65.19) mg/24 h vs. (115.16 ± 101.99) mg/24 h vs. (159.45 ± 149.08) mg/24 h,P ＜ 0.05], and the levels of high density lipoprotein cholesterol decreased in group B and group C[(1.21 ± 0.37) mmol/L vs.(1.05 ± 0.38) mmol/L vs. (0.99 ± 0.21) mmol/L,P ＜ 0.05]. Multiple stepwise regression analysis showed that triglyeride was the most important risk factor affecting UAER(P ＜ 0.05). Conclusions There is a close relationship between NAFLD and UAER in T2DM. In the subjects with moderate or severe NAFLD, the UAER increases which indicates that these patients already have capillary vessel injury apparently.