Clinical outcomes in patients with type 2 diabetes mellitus-related kidney disease: A Jordanian population cohort study.

BACKGROUND: Diabetic kidney disease (DKD) increases the risk of cardiovascular (CV) complications, kidney disease progression, and mortality. We aimed to determine the incidence and risk of these outcomes according to DKD phenotype among the Jordanian population. METHODS: A total of 1172 type 2 diabetes mellitus patients with estimated glomerular filtration rates (eGFRs) of >30 ml/min/1.73 m2 were followed-up from 2019 to 2022. At baseline, patients were classified according to the presence of albuminuria (>30 mg/g creatinine) and reduced eGFR (<60 ml/min/1.73 m2) into four phenotypes: non-DKD (reference category), albuminuric DKD without decreased eGFR, non-albuminuric DKD with decreased eGFR, and albuminuric DKD with decreased eGFR. RESULTS: Mean follow-up was 2.9 ± 0.4 years. Overall, 147 patients (12.5 %) experienced CV events, while 61 (5.2 %) demonstrated kidney disease progression (eGFR: <30 ml/min/1.73 m2). The mortality rate was 4.0 %. Multivariable-adjusted risk for CV events and mortality was greatest for the albuminuric DKD with decreased eGFR group (hazard ratio [HR]: 1.45, 95 % confidence interval [CI]: 1.02-2.33 and HR: 6.36, 95 % CI: 2.98-13.59, respectively), with the risk increasing when adjusted for prior CV history (HR: 1.47, 95 % CI: 1.06-3.42 and HR: 6.70, 95 % CI: 2.70-16.60, respectively). Risk of a ≥40 % decline in eGFR was greatest for the albuminuric DKD with decreased eGFR group (HR: 3.45, 95 % CI: 1.74-6.85), followed by the albuminuric DKD without decreased eGFR group (HR: 1.6, 95 % CI: 1.06-2.75). CONCLUSION: Thus, patients with albuminuric DKD and decreased eGFR were at greater risk for poor CV, renal, and mortality outcomes compared to other phenotypes.

Hypolipidemic and hepatoprotective seeds mixture diet rich in omega-3 and omega-6 fatty acids.

In vitro physicochemical and antioxidant properties of mixture of Flax/Sesame (LS) and Flax/Peanut (LA) and in vivo hypolipidemic, antioxidant and hepatoprotective activities were carried out to ascertain the claim of its utilisation against diseases. The seeds mixture rich in unsaturated fatty acids were prepared with 5/1 ratio of omega-6/omega-3 fatty acids and were orally administered ad libitum to rats by standard diet for 30 days. High cholesterol fed diet rats (CD-chol) exhibited a significant increase in total plasma and liver lipid parameters and atherogenicity and a significant decrease in high-density lipoproteins (HDL) and HDL/TC ratio (HTR). Administration of (LS) or (LA) seeds mixture to hypercholesterolemic rats (MS-LSchol and MS-LAchol groups respectively) significantly ameliorated lipid parameters and showed an increase of PUFAs (ALA and LA) and MUFAs and a decrease of SFAs in plasma and liver of MS-LSchol and MS-LAchol groups. Furthermore, malondialdehyde levels decreased and the efficiency of antioxidant defense system was improved compared to CD-chol group. Liver histological sections showed lipid storage in hepatocytes of CD-chol group and an improvement was noted in both supplemented groups. Our results suggested that seeds mixtures of Flax/Sesame and Flax/Peanut have anti-atherogenic and hepatoprotective effects.