RESUMEN
The aim of this study was to assess the relationship between urinary Smad1 and glomerular hyperfiltration (GHF) in type 2 diabetes mellitus (T2DM), and to explore the factors related to the urinary Smad1 in T2DM. The reference value of the estimated glomerular filtration rate (eGFR) was determined in 248 healthy individuals. 30 patients with GHF, 58 patients with norm-GFR T2DM, and 24 healthy patients who served as controls were recruited. Urinary Smad1, fasting plasma glucose (FPG), fasting serum C-Peptide (C-P), hemoglobin A1C (HbA1c), cystatin C, and other chemistry laboratory parameters of T2DM participants and controls were measured. Patients with GHF had higher levels of urinary Smad1 than the control group, and those with norm-GFR. For T2DM patients with body mass index, age, and gender adjustments, urinary Smad1 was positively correlated with FPG, HbA1C, and eGFR, but negatively correlated with fasting serum C-P. Multivariate linear regression analysis demonstrated that eGFR, HbA1C, and fasting serum C-P were independently associated with urinary Smad1. High levels of urinary Smad1 were found in GHF patients with T2DM, which may be another potential mechanism of GHF in relation to diabetic nephropathy.
Asunto(s)
Complicaciones de la Diabetes/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Nefropatías Diabéticas/fisiopatología , Tasa de Filtración Glomerular/fisiología , Proteína Smad1/orina , Adulto , Biomarcadores/metabolismo , Glucemia/metabolismo , Péptido C/sangre , Estudios de Casos y Controles , Estudios Transversales , Cistatina C/sangre , Complicaciones de la Diabetes/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Nefropatías Diabéticas/metabolismo , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Valores de ReferenciaRESUMEN
The purpose of this study was to investigate the prevalence of tubular damage in short-term (less than five years) type 2 diabetes mellitus (T2DM) patients and to explore the correlation between tubular markers and their relationship with renal indices at different stages of diabetic nephropathy. A group of 101 short-term T2DM patients and 28 control subjects were recruited. Tubular markers, such as neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-ß-D: -glucosaminidase (NAG), and kidney injury molecule 1 (KIM-1), as well as urinary albumin excretion were measured in voided urine. Glomerular filtration rate (GFR) was estimated via Macisaac's formula. The patients were further categorized into three groups, namely, the normoalbuminuria, microalbuminuria, and macroalbuminuria groups, according to their urine albumin/creatinine ratio (UACR). Urinary tubular markers were compared and their correlations with renal indices [UACR and estimated GFR (eGFR)] were analyzed among the different diabetic groups. Compared with the control group, Urinary NGAL [median (IQR)][83.6(41.4-138.7) µg/gcr vs. 32.9(26.1-64.5) µg/gcr], NAG [13.5(8.7-17.9) U/gcr vs. 7.6(6.5-13.0) U/gcr] and KIM-1 [120.0(98.4-139.9) ng/gcr vs. 103.1(86.8-106.2) ng/gcr] in the T2DM were all markedly increased. For all patients, urinary NGAL had stronger positive correlations with UACR than NAG (R = 0.556 vs. 0.305, both P < 0.05). In addition, only urinary NGAL showed a negative correlation with eGFR (R = -0.215, P < 0.05). Urinary KIM-1, however, showed no significant difference among the three T2DM groups and did not correlate with either UACR or eGFR. As UACR increased from the normoalbuminuria to the last macroalbuminuria group, all of the markers increased. However, only the concentrations of NGAL were statistically different among the three diabetic groups. The correlation between the tubular markers and their relationships with the renal indices differed markedly among the three T2DM groups. In conclusion, these results suggest that tubular damage is common in short-term T2DM patients. Urinary NGAL may be a promising early marker for monitoring renal impairment in short-term T2DM patients.
Asunto(s)
Acetilglucosaminidasa/orina , Proteínas de Fase Aguda/orina , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/orina , Nefropatías Diabéticas/epidemiología , Lipocalinas/orina , Glicoproteínas de Membrana/orina , Proteínas Proto-Oncogénicas/orina , Adulto , Anciano , Albuminuria/clasificación , Albuminuria/complicaciones , Albuminuria/epidemiología , Biomarcadores/orina , Estudios de Casos y Controles , Comorbilidad , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Tasa de Filtración Glomerular , Receptor Celular 1 del Virus de la Hepatitis A , Humanos , Lipocalina 2 , Masculino , Persona de Mediana Edad , Receptores Virales , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To investigate the effects of Rubus suavissimus S. Lee extract (RSE) on mice, and its influence on release of histamine from rat peritoneal mast cells induced by compound 48/80 in vitro. METHODS: To establish murine delayed-type-hypersensitive model induced by 2,4-dinitrofluotobenzene (DNFB) and sheep red blood cell (SRBC); murine type I allergic reaction induced by PCA, and then to observe the anti-allergic effect of RSE. HPLC-ECD methods were performed to detect the contents of histamine released from rat peritoneal mast cells induced by compound 48/80 in vitro. RESULTS: Compared with the model group, RSE could ameliorate the ear swelling and capillary permeability in mice induced by DNFB and PCA. RSE also reduced the thickness of the mice hind paw induced by SRBC in significant dose-dependent manner. Meanwhile, RSE obviously inhibited the release of histamine in rat peritoneal mast in vitro, a dose-dependent manner. CONCLUSION: RSE exerts potential anti-allergy effects and the mechanisms may be partly related to its inhibitory effect on the release of histamine from mast cells.