RESUMO
Objective:To observe the expression of serum nuclear factor-κB (NF-κB) and monocyte chemotactic protein-1 (MCP-1) in patients with early diabetic nephropathy (EDN) and the effect of pioglitazone on the expression of inflammatory factors and renal protective mechanism.Methods:A retrospective case-control study was conducted.From January 2019 to December 2019, the patients were divided into pioglitazone group ( n=35) and glimepiride group ( n=34). At the same time, 30 healthy people in the physical examination center of our hospital were selected as the control group.The levels of serum NF-κB and MCP-1 were detected by immunohistochemistry.The changes of fasting glucose, Hemoglobin A1C (HbA1c), renal function, urinary albumin excretion rate (UAER), and hypersensitive C-reactive protein(hsCRP), interleukin-6(IL-6), homeostasis model insulin Resistance index (HOMA-IR) were detected and compared among the three groups before treatment, pioglitazone group and glimepiride treatment group after treatment.To observe the effect of pioglitazone on serum NF-kB and MCP-1 expression in patients with early type 2 diabetic nephropathy. Results:Serum NF-κB, MCP-1, UAER, fasting blood glucose, HbA1c, HOMA-IR, hsCRP, IL-6 were significantly higher in the diabetic nephropathy group than those in the control group before treatment ( t values were 9.16, 7.61, 16.99, 17.01, 17.05, 12.01, 8.69, 6.28, all P<0.01). After 12 weeks of treatment, the levels of NF- κB, MCP-1, HOMA-IR, hsCRP, IL-6 and UAER in pioglitazone group were lower than those in glimepiide group ( t values were -5.03, -4.63, -2.35, -8.03, -3.06, -2.10, P<0.05 or P<0.01). After treatment, there were no statistically significant differences in fasting blood glucose and HbA1c between the pioglitazone group and the glimepiide group (all P>0.05). Serum NF-κB, MCP-1, HbA1c, HOMA-IR and UAER in EDN group were significantly positively correlated ( R values were 0.568, 0.532, 0.521, 0.466, all P<0.05). Conclusion:The expression of NF - κ B and MCP-1 in serum of EDN patients was increased, which indicated that there was chronic inflammation in patients.Pioglitazone could down regulate the expression of NF - κ B and MCP-1, so as to play an anti-inflammatory and renal protective role.
RESUMO
Clinical pharmacists actively participated in the glucose-lowering therapy for three type 2 diabetes patients with obesity and hepatic insufficiency to explore the role of clinical pharmacists in clinical treatment. Through the participation in the formulation of drug treatment by clinical pharmacists, GLP-1 preparation was used for hypoglycemic treatment, and the effect was promising. There was no significant change in the patients' liver function. By actively participating in the formulation of glucose-lowering therapy, clini-cal pharmacists can improve the effectiveness and safety of drug treatment.
RESUMO
The study intended to evaluate the atherosclerotic plaque burden and composition among symptomatic patients with and without type 2 diabetes mellitus.Total 262 symptomatic patients, including 79 with type 2 diabetes and 183 without, underwent multislice computed tomography coronary angiography.The extent of coronary atherosclerosis and 3 plaque types were studied.Patients with diabetes showed more diseased coronary segments ( P ＜ 0.01 ) and more nonobstructive segments ( P ＜ 0.05 ) than non diabetic patients.Compared to non diabetic patients,diabetic patients had a higher number of coronary segments with non-calcified ( P = 0.005 ) and calcified ( P = 0.016 ) plaques, but not for mixed plaques.The results indicate that type 2 diabetic patients have higher coronary plaque burden.
