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Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.
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Objective To investigate the relationship of serum level of 25 hydroxyl vitamin D3 [25(OH)D3 ] with insulin resistance (IR) and bone metabolism in diabetic patients with chronic kidney disease (CKD) . Methods From April 2012 to February 2014 ,200 diabetic patients with CKD were selected ,and they were divided into three groups according to eGFR:60 subjects in eGFR> 45 ~ 59 ml/(min?1.73 m2 ) group ,60 subjects in eGFR 30~44 ml/(min?1.73 m2 ) group and 80 subjects in eGFR 15~29 ml/(min?1.73 m2 ) group .Clinical features ,IR and indexes of bone metabolism among different groups were compared .Indexes of bone metabolism between two groups with different HOMA‐IR level were also compared . Results The difference of age ,gender ,BMI ,blood pressure and FPG among three groups had no statistical significance (P> 0 .05) .The difference of duration of diabetes mellitus ,duration of CKD ,urine protein ,blood lipid ,eGFR ,HbA1c ,FIns ,HOMA‐IR and indexes of bone metabolism had statistical significance (P< 0.05) .In 200 patients ,there were 129 patients (IR) with HOMA‐IR≥3.28 ,and 71 patients (non‐insulin resistance) with HOMA‐IR<3.28 .The difference of bone metabolism indexes between two groups had statistical significance (P<0.05) .The serum level of 25(OH)D3 was positively related to HOMA‐IR ,bone mineral density (BMD) at left proximal femur , BMD at lumbar ,P ,Ca and BSAP (P<0.05);while it was negatively related to osteoprotegerin and PTH (P<0 .05) . Conclusion The serum level of 25 (OH )D3 has relevance to IR and bone metabolism in diabetic patients with CKD .
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Objective To observe the changes of serum sialic acid(SA)and in diabetic patients with chronic kidney disease(CKD) and its relation with vascular endothelial function. Methods 97 T2DM patients were divided into <30 mg/24 h group(n=31) ,30~299 mg/24 h group(n=34) and ≥300 mg/24 h group(n=32) according to the level of UAlb/Cr ,meanwhile 30 healthy subjects were selected as normal control(NC) group. The level of serum SA ,nitric oxide (NO) ,endothelin‐1(ET‐1) in four groups were detected. Results Compared with the NC group ,the level of SA and ET‐1 were increased gradually in <30 mg/24 h ,30 ~ 299 mg/24 h and ≥ 300 mg/24 h group ,and the NO were decreased gradually ( P<0.05) .Pearson correlation analysis showed that the SA level was positively related with ET‐1 and negatively with NO(P<0.05). Conclusion The level of SA is increased gradually in the development of CKD ,and the SA level is correlated with NO and ET‐1.
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Objective To explore the level of angiopoietin‐like protein 4 (ANGPTL4) in patients with early chronic kidney disease (CKD ) in diabetes and the influence of pioglitazone on the level. Methods 92healthypeoplewithnormalglucosetolerancewereselectedasthecontrols(NCgroup).89 newly diagnosed T2DM were selected (T2DM group ). 90 cases of CKD group were divided into pioglitazone (PGZ) and glimepiride (GLI) treated subgroups ,45 cases in each subgroup. After treatment , serum ANGPTL4 levels were observed in CKD group. Results There were significant differences in serum ANGPTL4 levels among NC ,T2DM and CKD groups [(34.8 ± 4.75) vs (31.1 ± 3.65) vs (27.1 ± 3.52)ng/ml ,P 0.05 ;(99.70 ± 12.80 ) vs (122.40 ± 13.10 )mg/24 h ,P < 0.05]. HbA1 c ,FIns ,UAlb/Cr were the independent related factors influencing ANGPTL4 of CKD patients. Conclusion Serum ANGPTL4 has a lower level in CKD patients. PGZ is effective in treating CKD. This role is associated with the increase of serum ANGPTL4.