目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观...目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观察组接受达格列净联合维格列汀治疗,观察两组治疗前及治疗12周的血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、肾功能(uPCR、eGFR)、血清血管内皮功能指标[血管内皮生长因子(VEGF)、血管生成素1(Ang1)、ET-1]及其他血清生化指标[转化生长因子β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-1(TIMP-1)]水平变化。结果治疗12周后,两组FBG、2 h PG、HbA1c、HOMA-IR、uPCR水平低于治疗前(P<0.05),eGFR水平高于治疗前(P<0.05),两组血清VEGF、Ang1、ET-l、TGF-β1及TIMP-1水平低于治疗前(P<0.05),血清MMP-9水平高于治疗前(P<0.05),以上指标观察组的变化幅度大于对照组(P<0.05)。结论达格列净联合维格列汀能有效控制老年DN患者的血糖水平,改善胰岛β细胞功能和肾功能,抑制血清ET-1等血管内皮功能指标和TGF-β1、TIMP-1水平,并可上调MMP-9水平。展开更多
BACKGROUND Proteinuria is an important and well-known biomarker of many forms of kidney injury.Its quantitation is of particular importance in the diagnosis and management of glomerular diseases.Its quantification can...BACKGROUND Proteinuria is an important and well-known biomarker of many forms of kidney injury.Its quantitation is of particular importance in the diagnosis and management of glomerular diseases.Its quantification can be done by several methods.Among these,the measurement of 24-h urinary protein excretion is the gold standard method.However,it is cumbersome,time-consuming,and inconvenient for patients and is not completely foolproof.Many alternative methods have been tested over time albeit with conflicting results.Among the latter,the measurement of urine protein-to-creatinine ratio(uPCR)in singlevoided urinary samples is widely used.The majority of studies found a good correlation between uPCR in single urine samples with 24-h urinary protein estimation,whereas others did not.AIM To investigate the correlation of spot uPCR with 24-h urinary protein estimation in patients suffering from different forms of glomerulopathies at a single largevolume nephrological center in Pakistan.METHODS This cross-sectional,observational study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan from September 2017 to March 2018.All newly presenting adult patients with proteinuria who were being investigated for suspected glomerulonephritis and persistent proteinuria with ages between 18 to 60 years were enrolled.All patients were given detailed advice regarding 24-h urine collection starting at 7:00 AM for total protein and creatinine excretion estimations.A spot urine sample was collected the next day at the time of submission of a 24-h urine sample for measuring uPCR along with a blood sample.The data of patients were collected in a proforma.SPSS version 20.0 was used for statistical analysis.RESULTS A total of 157 patients were included.Their mean age was 30.45±12.11 years.There were 94(59.8%)males and 63(40.2%)females.The mean 24-h urinary protein excretion was 3192.78±1959.79 mg and the mean spot uPCR was 3.16±1.52 in all patients.A weak but significant correlation展开更多
文摘目的探讨达格列净联合维格列汀治疗老年糖尿病肾病(DN)患者的效果及对尿蛋白与肌酐比值(uPCR)、肾小球滤过率(eGFR)和血清内皮素-1(ET-1)水平的影响。方法选取98例老年DN患者,随机分为对照组和观察组,各49例,对照组接受维格列汀治疗,观察组接受达格列净联合维格列汀治疗,观察两组治疗前及治疗12周的血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)及糖化血红蛋白(HbA1c)]、胰岛素抵抗指数(HOMA-IR)、肾功能(uPCR、eGFR)、血清血管内皮功能指标[血管内皮生长因子(VEGF)、血管生成素1(Ang1)、ET-1]及其他血清生化指标[转化生长因子β1(TGF-β1)、基质金属蛋白酶-9(MMP-9)、组织金属蛋白酶抑制剂-1(TIMP-1)]水平变化。结果治疗12周后,两组FBG、2 h PG、HbA1c、HOMA-IR、uPCR水平低于治疗前(P<0.05),eGFR水平高于治疗前(P<0.05),两组血清VEGF、Ang1、ET-l、TGF-β1及TIMP-1水平低于治疗前(P<0.05),血清MMP-9水平高于治疗前(P<0.05),以上指标观察组的变化幅度大于对照组(P<0.05)。结论达格列净联合维格列汀能有效控制老年DN患者的血糖水平,改善胰岛β细胞功能和肾功能,抑制血清ET-1等血管内皮功能指标和TGF-β1、TIMP-1水平,并可上调MMP-9水平。
文摘BACKGROUND Proteinuria is an important and well-known biomarker of many forms of kidney injury.Its quantitation is of particular importance in the diagnosis and management of glomerular diseases.Its quantification can be done by several methods.Among these,the measurement of 24-h urinary protein excretion is the gold standard method.However,it is cumbersome,time-consuming,and inconvenient for patients and is not completely foolproof.Many alternative methods have been tested over time albeit with conflicting results.Among the latter,the measurement of urine protein-to-creatinine ratio(uPCR)in singlevoided urinary samples is widely used.The majority of studies found a good correlation between uPCR in single urine samples with 24-h urinary protein estimation,whereas others did not.AIM To investigate the correlation of spot uPCR with 24-h urinary protein estimation in patients suffering from different forms of glomerulopathies at a single largevolume nephrological center in Pakistan.METHODS This cross-sectional,observational study was conducted at the Department of Nephrology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan from September 2017 to March 2018.All newly presenting adult patients with proteinuria who were being investigated for suspected glomerulonephritis and persistent proteinuria with ages between 18 to 60 years were enrolled.All patients were given detailed advice regarding 24-h urine collection starting at 7:00 AM for total protein and creatinine excretion estimations.A spot urine sample was collected the next day at the time of submission of a 24-h urine sample for measuring uPCR along with a blood sample.The data of patients were collected in a proforma.SPSS version 20.0 was used for statistical analysis.RESULTS A total of 157 patients were included.Their mean age was 30.45±12.11 years.There were 94(59.8%)males and 63(40.2%)females.The mean 24-h urinary protein excretion was 3192.78±1959.79 mg and the mean spot uPCR was 3.16±1.52 in all patients.A weak but significant correlation
