RESUMO
BACKGROUND AND AIMS: Diabetic kidney disease (DKD) is associated with lipid derangements that worsen kidney function and enhance cardiovascular (CVD) risk. The management of dyslipidemia, hypertension and other traditional risk factors does not completely prevent CVD complications, bringing up the participation of nontraditional risk factors such as advanced glycation end products (AGEs), carbamoylation and changes in the HDL proteome and functionality. The HDL composition, proteome, chemical modification and functionality were analyzed in nondialysis subjects with DKD categorized according to the estimated glomerular filtration rate (eGFR) and urinary albumin excretion rate (AER). METHODS: Individuals with DKD were divided into eGFR> 60 mL/min/1.73 m2 plus AER stages A1 and A2 (n = 10) and eGFR< 60 plus A3 (n = 25) and matched by age with control subjects (eGFR> 60; n = 8). RESULTS: Targeted proteomic analyses quantified 28 proteins associated with HDL in all groups, although only 2 were more highly expressed in the eGFR< 60 + A3 group than in the controls: apolipoprotein D (apoD) and apoA-IV. HDL from the eGFR< 60 + A3 group presented higher levels of total AGEs (20%), pentosidine (6.3%) and carbamoylation (4.2 x) and a reduced ability to remove 14C-cholesterol from macrophages (33%) in comparison to HDL from controls. The antioxidant role of HDL (lag time for LDL oxidation) was similar among groups, but HDL from the eGFR< 60 + A3 group presented a greater ability to inhibit the secretion of IL-6 and TNF-alpha (95%) in LPS-elicited macrophages in comparison to the control group. CONCLUSION: The increase in apoD and apoA-IV could contribute to counteracting the HDL chemical modification by AGEs and carbamoylation, which contributes to HDL loss of function in well-established DKD.
Assuntos
Apolipoproteínas A/sangue , Apolipoproteínas D/sangue , Nefropatias Diabéticas/sangue , Lipoproteínas HDL/sangue , Proteoma/metabolismo , Idoso , Idoso de 80 Anos ou mais , Albuminúria/sangue , Albuminúria/genética , Albuminúria/patologia , Apolipoproteínas A/genética , Apolipoproteínas D/genética , Arginina/análogos & derivados , Arginina/sangue , Arginina/genética , Estudos de Casos e Controles , Nefropatias Diabéticas/genética , Nefropatias Diabéticas/patologia , Feminino , Expressão Gênica , Taxa de Filtração Glomerular , Produtos Finais de Glicação Avançada/sangue , Produtos Finais de Glicação Avançada/genética , Humanos , Interleucina-6/genética , Interleucina-6/metabolismo , Rim/metabolismo , Rim/patologia , Lipopolissacarídeos/farmacologia , Lipoproteínas HDL/genética , Lisina/análogos & derivados , Lisina/sangue , Lisina/genética , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Macrófagos/patologia , Masculino , Pessoa de Meia-Idade , Cultura Primária de Células , Carbamilação de Proteínas , Proteoma/classificação , Proteoma/genética , Diálise Renal , Fatores de Risco , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/metabolismoRESUMO
INTRODUCTION: Continuous glucose monitoring system is a valuable instrument to measure glycemic control, which uses a retrospective calibration based upon 3 to 4 capillary glucose meter values inserted by the patient each day. OBJECTIVE: We evaluated the interference of calibration during the dawn period in the system accuracy. METHODS: The monitoring data were retrospectively divided into two groups: with (Group A) or without (Group B) the dawn period calibration (between 1:00 and 5:00 AM). Accuracy of the method was expressed by relative absolute difference. RESULTS: Thirty-four continuous glucose monitoring data were evaluated comprising a total of 112 nights. A total of 289 paired readings were analyzed - 195 in Group A and 94 in Group B. We did not find a difference in relative absolute difference (RAD%) in any analyzed period of day by adding dawn calibration. CONCLUSIONS: These data suggest that dawn calibration does not alter accuracy of method.
Assuntos
Automonitorização da Glicemia/métodos , Glicemia/metabolismo , Ritmo Circadiano , Diabetes Mellitus/sangue , Adolescente , Adulto , Automonitorização da Glicemia/normas , Calibragem , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto JovemRESUMO
INTRODUCTION: Continuous glucose monitoring system is a valuable instrument to measure glycemic control, which uses a retrospective calibration based upon 3 to 4 capillary glucose meter values inserted by the patient each day. OBJECTIVE: We evaluated the interference of calibration during the dawn period in the system accuracy. METHODS: The monitoring data were retrospectively divided into two groups: with (Group A) or without (Group B) the dawn period calibration (between 1:00 and 5:00 AM). Accuracy of the method was expressed by relative absolute difference. RESULTS: Thirty-four continuous glucose monitoring data were evaluated comprising a total of 112 nights. A total of 289 paired readings were analyzed - 195 in Group A and 94 in Group B. We did not find a difference in relative absolute difference (RAD%) in any analyzed period of day by adding dawn calibration. CONCLUSIONS: These data suggest that dawn calibration does not alter accuracy of method.
INTRODUÇÃO: O CGMS (sigla do inglês continuous glucose monitoring system) é um instrumento valioso no controle glicêmico e utiliza uma calibração por meio de 3 ou 4 medidas de glicemia capilar inseridas pelo paciente em cada dia do exame. OBJETIVO: Avaliar a interferência da calibração durante a madrugada na acurácia do sistema. MÉTODOS: Os dados das monitorizações foram divididos retrospectivamente em dois grupos: com (Grupo A) ou sem (Grupo B) a calibração da madrugada (entre 1:00 e 5:00 AM). A acurácia do método foi mostrada pela diferença relativa absoluta (DRA por cento). RESULTADOS: Trinta e quarto dados de monitorização foram avaliados em um total de 112 noites. Um total de 289 leituras pareadas foi analisado - 195 no Grupo A e 94 no Grupo B. Não foi encontrada diferença em DRA% em nenhum período do dia quando adicionada a calibração durante a madrugada. CONCLUSÕES: Esses dados sugerem que a calibração da madrugada não altera a acurácia do método.
