Showing 7 results for Diabetic Nephropathy
Manouchehr Nakhjavani, Farid Azmoudeh-Ardalan, Arman Mazouji,
Volume 1, Issue 2 (7-2002)
Abstract
Introduction: The urinary excretion of minimal quantities of albumin (microalbuminuria) is predictive of renal failure and cardiovascular mortality. The detection and prompt treatment of microalbuminuria is crucial to the prevention and progress of renal failure in patients with diabetes. The aim of this study is to evaluate the relative frequency of microalbuminuria in different age groups of men and women attending the diabetes clinic at Imam Khomeini University Hospital.
Methods: 123 patients each provided a 12-hour urine sample, collected in standard fashion. Urinary albumin was measured by immunoturbidometry. The frequency of microalbuminuria (urinary albumin excretion between 30mg and 300mg in a 24-hour sample) was assessed in different age groups in men and women, according to duration of diabetes, glomerular filtration rate (GFR), glycosylated haemoglobin levels (A1C), body mass index (BMI), and both systolic and diastolic blood pressure.
Results: Overall, 20.3% of patients had microalbuminuria, 61.1% normoalbuminuria, and 10.6% macroalbuminuria. Patients with microalbuminuria were significantly older (mean age = 58.5 years) than patients with normal albumin excretion (50.3 years). The male-to-female ratio was highest in patients with microalbuminuria and lowest in those with normoalbuminuria. There was no significant difference in GFR, A1C, and blood pressure between patients with normo-, micro-, or microalbuminuria. There was a significant difference in duration of diabetes between normoalbuminuric (9.3 years) and microalbuminuric patients (11.5 years). There was a significant, inverse correlation between BMI and urinary albumin excretion.
Conclusions: Renal function in patients with type 2 diabetes deteriorates with increasing age and duration of diabetes. Renal impairment is more common in men than women.
Javad Tavakkoly Bazzaz, Vera Pravica, Andrew Jm Boulton, Ian V Hutchinson,
Volume 4, Issue 4 (6-2005)
Abstract
Background: Despite substantial progress in the clinical management of diabetes, diabetic nephropathy (DN) still occurs recurrently, implicating diabetes as the major underlying condition leading to the end stage renal disease. One of the main reasons is the influential role of genetic or inherited backgrounds of diabetics that are almost overlooked in daily practice. Owing to be orchestrated by the genetic makeup, cellular and molecular responses are different to similar metabolic disturbances. This in turn defines susceptibility/resistance state of the host to chronic diabetic complications, including DN. Separate analysis of every single gene that may be involved in genetics of a multi-factorial disease (such as DN) is the only available way to dissect the genetic basis of the disease and overcome its complexity.
Among different genes accountable for DN, Transforming Growth Factor (TGF)-1 has an exceptional place. TGF-1 has profound impact on cell growth and proliferation, and in particular the regulation of extra cellular matrix deposition, branding it as a "pro-fibrotic" and "hypertrophic" mediator.
Methods: By employing ARMS-PCR technique, the genetic susceptibility to DN was studied in 248 patients with T1DM (86 DN+, 162 DN−) and 113 healthy controls, all from British Caucasian origin. The analysis of two functional TGF-1 gene variations, which change codons 10 (+869*C/T) and 25 (+915*G/C) was carried out.
Results: There were some differences in alleles/genotypes distribution, but no significant association was apparent in patients as a whole or DN+/DN− subgroups and controls (P=NS).
Conclusion: The negative result of this study may be false. As DN is a mortal disability, some fraction of risky genotypes associated with DN may previously be excluded by death. Such under-representation of the risky-genotypes (selective survivor effect) can be avoided by carrying out a prospective study. However, if the non-association result is true, it may question the functionality and reliability of the examined polymorphisms at least in the context of diabetes. Moreover, it does not underestimate the role of TGF-1 at the level of gene/protein themselves in development of DN.
Marzieh Arshadi Mashkani, Mahsa Mohammad Amoli, Iman Salahshorifar, Farideh Razi,
Volume 16, Issue 3 (3-2017)
Abstract
Background: Diabetes is the most common endocrine disorder that affects many people every year. Diabetic nephropathy is main complication of diabetes type 2. Renoprotective effects of vitamin “D” in chronic kidney disease have been reported that including diabetic nephropathy. The purpose of this study is to investigate the association between polymorphism (rs731236 (Taq1)) at gene receptor vitamin D (VDR), and the risk of diabetic nephropathy in patients with type 2 diabetes.
Methods In this case-control study, 104 patients with type 2 diabetes and nephropathy, 100 patients with type 2 diabetes and no nephropathy, and 98 people without diabetes and nephropathy who referred to the Diabetes Clinic of Tehran University of Medical Sciences were included . Clinical data were obtained and biochemical parameters were measured. The DNA samples were extracted from blood samples by phenol chloroform method. TheTaqI polymorphism (rs731236) was studied by TaqMan specific genotypes.
Results: Urea, creatinine and urine albumin values were significantly higher and glomerular filtration rate was lower in nephropathy group. Although frequency of TT genotype and also T allele was higher in nephropathy group, the difference was not significant.
Conclusion: There was no association between Taq1 polymorphism and diabetic nephropathy in the studied population
Saeedeh Asgarbeik, Mahsa Mohammad Amoli, Seyed Abdolhamid Angaji, Farideh Razi, Ensieh Nasli Esfahani,
Volume 16, Issue 3 (3-2017)
Abstract
Background: Diabetic Nephropathy is one of the main microvascular complications of diabetic mellitus. Methylenetetrahydrofolate Reductase (MTHFR) is one of the candidate genes of diabetic nephropathy. MTHFR (C677T) polymorphism reduces catalytic activity of MTHFR and leads to increase level of plasma homocysteine. The aim of this study was to evaluate the association of C677T polymorphism with diabetic nephropathy.
Methods: In this case control study, 300 individuals, including type 2 diabetes mellitus with diabetic nephropathy (N=104), diabetes mellitus patients without diabetic nephropathy (N=100) and controls (N=96) participated. The MTHFR genotype was determined using PCR-RFLP technique and biochemical parameters were measured.
Results: Genotype frequencies were significantly different between patients with diabetic nephropathy and diabetes mellitus without nephropathy (TT+CT vs CC; P=0.02,OR:0.5,CI:0.3-0.9).The allele frequency was also significantly different between diabetic nephropathy and diabetics mellitus without nephropathy(P=0.013,OR:1.754,CI:1.123-2.740).
Conclusion: These findings suggest that there is an association between C677T polymorphism and nephropathy in patients with type 2 diabetes. Allele C increase the risk of nephropathy, and T allele has a protective role in susceptibility to disease.
Ali Jalili, Bagher Larijani, Farideh Razi, Ensieh Nasli, Mostafa Qorbani,
Volume 16, Issue 6 (10-2017)
Abstract
Background: Diabetic nephropathy is a chronic kidney disease and of more common complications of type 2 diabetes mellitus. The current diagnostic markers of diabetic nephropathy, albumin and creatinine, are only able to catch the disease in the stage of renal damage. The aim of this study is evaluation of targeted metabolomics of serum amino acids to identify the association of the changes of serum amino acid profile with diabetes and diabetic nephropathy.
Methods: This cross-sectional study was conducted in 2015-2016 on thirty patients with type 2 diabetes subsequent diabetic nephropathy and thirty type 2 diabetic patients without nephropathy attending diabetes clinic of endocrinology and metabolism institute and thirty non diabetic persons. Blood hemoglobin, HbA1c and BUN and also, serum albumin, uric acid and the albumin/creatinine ratio from a random urine specimen were measured by standard methods and serum amino acids level were identified using high performance liquid chromatography (HPLC). Statistical analysis ANOVA, Kruskal-Wallis, and nominal regression were used for the comparison of the investigated groups.
Results: significant differences were seen in serum levels of 8 essential, branched-chains, aromatic and 8 non-essential amino acids alanine, aspartic acid, serine, glutamine, arginine, glycine, tyrosine and ornithine between three groups. Serum levels of arginine and isoleucine were higher in the diabetic group than non-diabetics. However, Levels of amino acids serine, glutamine, glycine, threonine, tyrosine, tryptophan, methionine, valine, ornithine, and lysine in 2 groups of diabetic nephropathy and diabetes were higher than non-diabetic patients.
For every standard deviation decrease in serum levels of amino acids serine, alanine and isoleucine, in comparison to diabetic patients, the risk of diabetic nephropathy were increased 3.257 (95%CI: 0.10- 0.94, P=0.039), 2.207 (95%CI: 0.18- 0.81, P=0.039) and 2.652 (0.21- 0.96, P=0.012), respectively.
Conclusion: Since this study was conducted in patients in the early stages of the disease, reduced serum levels of the amino acids serine, leucine and alanine may be associated with development and progression of diabetic nephropathy. and in the future with more studies in this field can be used in metabolic control and improvement of the prognosis of patients with diabetic nephropathy.
Narges Shafaei Bajestani, Maryam Aradmehr, Ensieh Nasli Esfahani, Behrooz Khiabani Tanha,
Volume 18, Issue 2 (2-2019)
Abstract
Background: Diabetes is one of the most dangerous and common diseases of the modern world. Since medical research usually has limited data available and medical data is very ambiguous, it seems appropriate to use the fuzzy model to find out the relationship between input and output in medical data. None of the previous articles of fuzzy regression have been used to predict complications of diabetes, including nephropathy. Therefore, in this study, a fuzzy regression model was used to predict nephropathy in a diabetic patient.
Methods: In the present study, GFR results of previous patient experiments were used to predict a deeper horizons of GFR and ultimately to predict renal disease. Chronic kidney disease has been stratified based on the amount of GFR, that fuzzy data has been constructed based on these levels. The GFR prediction was performed in the following steps. Step 1: Define fuzzy sets based on the GFR level, which is considered for each level of a fuzzy set. Step 2: Fuzzify patient data Based on fuzzy sets. Step 3: GFR prediction with fuzzy regression model. Step 4: Defuzzifying the predictions. Step 5: Evaluating the model efficiency. The RMSE error is used to compare the performance of the model.
Results: The results of GFR prediction showed that comparison RMSE was 10.09 with using simple linear regression model and 4.24 in fuzzy model.
Conclusions: fuzzy regression model can predict nephropathy in diabetic patients.
Farnaz Onsori, Mina Akbari Rad, Maryam Emadzadeh, Ali Moradi, Mohammad-Javad Mojahedi, Alireza Shariati, Mohammad-Ali Yaghoubi,
Volume 23, Issue 3 (9-2023)
Abstract
Background: Diabetic nephropathy is the main cause of end-stage kidney disease in diabetic patients. Several inflammatory markers related with diabetic nephropathy have been investigated so far. It is necessary to identify easily available and cost-effective indices. We aimed to determine the relationship between the neutrophil to lymphocyte ratio and mean platelet volume with diabetic nephropathy.
Methods: This cross-sectional study was performed from 2021 to 2022 in diabetes clinic of Ghaem hospital, Mashhad. Patients with type II diabetes were categorized into two groups: without and with nephropathy (urinary albumin excretion greater than 30 mg/24h or GFR less than 60). Patients’ data, including demographic data, past medical and drug history and lab data were gathered and analyzed.
Results: In total, 100 diabetic patients including 50 with (mean age=64.04±7.40 years) and 50 without nephropathy (mean age=56.06±6.36 years), were studied. Patients with nephropathy were older, had a longer history of diabetes and a higher blood pressure (P < 0.05). However, the distribution of gender, weight, height, and BMI was not significantly different the two groups (P>0.05). The absolute neutrophil count was not significantly different between the two groups (P>0.05), while the mean platelet volume, neutrophil% and neutrophil/lymphocyte ratio were significantly higher in patients with nephropathy (P<0.05).
Conclusion: According to our findings, patients with diabetic nephropathy had higher mean platelet volume, neutrophil%, and neutrophil/lymphocyte ratios compared to diabetic patients without nephropathy.
