ABSTRACT
Objective To investigate the predictive values of hypoxia-induced factor(HIF)- 1α and vascular endothelial growth factor (VEGF) in patients with type 2 diabetic kidney disease, and its relationship between HIF-1α, VEGF and glomerular filtration rate (eGFR). Methods Seventy-six patients with type 2 diabetic kidney disease were divided into two groups:DKD1 group [eGFR>90 mL/(min·1.73 m2),n=48] and DKD2 group [60 mL/(min·1.73 m2)0.05). Serum levels of HIF-1α and VEGF were significantly higher in DKD2 group than those of DKD1 group (P<0.05). There were negative correlation between VEGF and HIF-1αlevels with eGFR level (r=-0.59, P<0.01;r=-0.55, P<0.01). ROC curve showed that serum VEGF and HIF-1αlevels were above the opportunity diagonal. The diagnostic sensitivities of HIF-1 to DKD1 and DKD2 were 92.1%and 87.4%. The diagnostic specificities of HIF-1 to DKD1 and DKD2 were 91.7%and 85.4%. The diagnostic sensitivities of VEGF to DKD1 and DKD2 were 96.1%and 86.2%, and specificities were 93.3%and 89.1%. Conclusion Serum levels of VEGF and HIF-1αchange with the severity of diabetic nephropathy are likely to be an early predictor for the progression of diabetic kidney disease.
ABSTRACT
Objective_ To investigate the effect of resting heart rate on the progression to diabetes in impaired glucose regulation patients. Methods A total of 638 patients with impaired glucose regulation, from January 2011 to December 2012 in our endocrinology clinic, were selected for the study. According to the resting heart rate, patients were divided into four groups:75 beat/min groups. All patients'baseline data were collected. The incidences of diabetes in different resting heart rate groups were compared, and the relationship between resting heart rate and the progression to diabetes was estimated using multiple regression analysis. Results In 704 patients with impaired glucose regulation, 636 patients have been completed 2 years follow-up, or reached the end of follow-up ( diagnosed as diabetes ) , the follow-up rate was 90. 34%. During two years follow-up, the incidence of diabetes of75 beat/min group were 16. 2%, 19. 4%, 25. 0%, and 33. 0%, respectivlely. And the Cochran Armitage trend test showed that χ2 =11. 109, P=0. 001, the difference was statistically significant ( P<0. 05). According to blood glucose monitoring, the 636 patients with impaired glucose regulation were divided into impaired fasting glucose group, impaired glucose tolerance group and impaired fasting glucose combined with impaired glucose tolerance group:the Cochran Armitage trend test showed that, with the resting heart rate accelerating, the incidence of diabetes increased. The incidence of diabetes in impaired fasting glucose combined with impaired glucose tolerance group was higher than that of impaired fasting glucose group and impaired glucose tolerance group ( P=0. 062, 0. 113). The average resting heart rate in 68 impaired glucose regulation patients progressed to diabetes was (79.8±8.3)beat/min,andin568non-diabetescases,itwas(74.5±7.2)beat/min(t=-5.043,P<0.01). With the use of patients progressing to diabetes as the dependent variable, different resting heart rate group as independent variables, and resting heart rate<66 beat/min group as a reference, the logistic regression analysis showed that the risk of the progression to diabetes increased with the resting heart rate levels. Conclusion Higher resting heart rate is linked to higher risk of diabetes in patients with impaired glucose regulation.