RESUMO
Objective To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy.Methods A total of 368 patients with type 2 diabetes mellitus were retrospectively collected.Early diabetic nephropathy was defined as 24h UMA 30～＜300 mg/24h.The correlation between ACR and 24hUMA,and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated.Gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy,respectively.A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy.Results The correlation between ACR and 24h UMA was 0.658.The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol,respectively.The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments.The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061).Conclusion ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender,age,course of disease,blood sugar,lipid,and blood pressure.
RESUMO
Objective To investigate the effect of tacrolimus on the function of islet beta cells in mature SD rats.Methods 72 Healthy SD rats were divided into 4 groups by random number table:High dose group (group H),middle dose group (group M),low dose group (group L) and control group,18 for each group.Measured body weight every 3 days and monitored fasting blood glucose every month.Fasting serum insulin levels (FINS) was determined by enzyme-linked immunoasaay (ELISA) after 1 month and 4 months later.The histological structure of islets were observed by HE staining.Results The clinical symptoms of polydipsia and polyuria in rats after 4 months in group H and M group tacrolimus irrigation group were presented,and the weight growth rate was lower than earlier;There was no significant change in blood glucose within one month of each group,as the duration of drug administration was extended,the blood glucose levels of the experimental groups gradually increased significantly and were positively correlated with the concentration;In the early stage of insulin level,the insulin secretion was negatively correlated with the concentration of tacrolimus;After 1 month,HE staining the pancreatic structure was clear and the islet structure was intact,After 4 months,the pancreatic tissue structure of H and M group was destroyed.Conclusion The short-term use of tacrolimus will not cause damage to the function of beta cells of the islet,but long-term use may gradually lead to the damage of beta cell function,and these changes are closely related to the concentration of tacrolimus.