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Journal of Chinese Physician ; (12): 1479-1482, 2017.
Article in Chinese | WPRIM | ID: wpr-667598


Objective To investigate the changes of visual acuity,fundus changes,and serum vitamin D concentration in diabetic retinopathy patients treated with metformin,and to evaluate its clinical efficacy.Methods Totally 80 cases (160 eyes) patients with background diabetic retinopathy were included in the study,and were divided into observation group (metformin + Pancreatic Kininogenase Enteric-coated Tablets) and control group (Pancreatic Kininogenase Enteric-coated Tablets) according to the different treatment methods used for 3 months.Fundus fluorescein angiography was used to evaluate the improvement of the fundus lesions.The serum levels of vitamin D were measured with electrochemiluminescence immunoassay (ECLIA).Results After 3 months of treatment,serum vitamin D concentration of the observation group increased,and the differences were statistically significant (P < 0.05) when compared to before treatment.However,3 months after treatment,serum vitamin D levels of the control group increased slightly,but the difference was not statistically significant (P > 0.05).The total effective rate of fundus improvement in the observation group and the control group was 70% and 55%,respectively.There was significant difference between the two groups in the improvement of fundus (P < O.05).Conclusions Metformin has an adjunctive effect on background diabetic retinopathy,and the increase of serum vitamin D may be one of the mechanisms of metformin in improving diabetic retinopathy.

Journal of Chinese Physician ; (12): 1483-1487, 2017.
Article in Chinese | WPRIM | ID: wpr-667513


Objective To explore the role of transforming growth factor-β1/serum and glucocorticoid induced kinase 1 (TGF-β1/SGK1) signaling pathway in diabetic nephropathy (DN).Methods Totally 60 clean grade healthy male Sprague-Dawley (SD) rats were divided into normal control (Con group,n =20) and diabetic model group (diabetic group,n =40).Type 2 diabetic animal model was induced by intraperitoneal injection of streptozotocin (STZ,45 mg/kg) to SD rats.Half of rats in each group were sacrificed after implemented for 4 weeks and 8 weeks,respectively.Fasting glucose,serum urea and creatinine,as well as urine protein in 24 h were detected.Pathological changes of rats' kidney cortex tissue were examined by hematoxylin-eosin staining.The expression of SGK1 was detected by immunohistochemistry in renal tissue.The mRNA level of SGK1 was analyzed by real-time polymerase chain reaction (PCR).The protein expression of TGF-β1 and SGK1 were determined by Western blotting.Results Compared to the control group,the blood glucose of the diabetic group rats was significantly increased,kidney hypertrophy index,serum urea and creatinine,24 h urine volume and urinary microalbumin as well as kidney index were significantly higher (P <0.05).The mRNA expressed of SGK1,protein expression of TGF-β1 and SGK1 were also increased obviously in the renal cortex of diabetic rats (all P < 0.05 vs Control).Conclusions TGF-β1/SGK1 signaling pathway is closely related to the TIF damage of kidney cortex in diabetic rats.

Journal of Chinese Physician ; (12): 1328-1332, 2014.
Article in Chinese | WPRIM | ID: wpr-465977


Objective To investigate the effects of alpha lipoic acid on patients with diabetic retinopathy (DR),explore the possible mechanisms,and provide experimental evidence for the treatment of DR with lipoic acid.Methods Totally 75 DR patients were randomly divided into control group and treatment group.Patients in control group received the standard hypoglycemic treatment,antihypertensive therapy,and other comprehensive treatment.Patients from the treatment group were treated with alpha lipoic acid 600 mg + 250 ml 0.9% sodium chloride injection additionally,avoiding light intravenous therapy,for a total of 4 weeks.Before and after treatment,fundus fluorescein angiography and visual inspection were detected in two groups.In addition,serum level of asymmetric dimethylarginine (ADMA) were detected with high performance liquid chromatography,serum lipid peroxidation product malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were detected to reflect the in vivo oxidative stress before and after treatment in two groups.Results Compared to the control group,visual acuity was improved significantly (P < 0.05),and total efficiency of ocular lesions-improved was increased significantly (84.21% vs 40.54%,x2 =15.28,P < 0.01).Serum levels of endogenous inhibitor of nitric oxide synthase ADMA [(0.32 ±0.13) μmol/L vs (0.51 ± 0.26) μmol/L,P < 0.05] and MDA [(3.22 ± 0.90) nmol/L vs (5.13 ± 0.42) nmol/ml,P < 0.05] were significantly decreased,while SOD levels [(72.68 ± 1.31) U/ml vs (53.16 ± 1.54) U/ml,P <0.05] were significantly increased in DR patients after alpha lipoic acid treatment.Conclusions Alpha lipoic acid had some therapeutic effects for DR patients,which mainly lied in the improvement of visual acuity and eye disease,might be related to the decrease of oxidative stress and serum level of endogenous nitric oxide synthase (NOS) inhibitor ADMA.