Abstract

Objective To investigate the effect of lipoic acid on urinary microalbumin and inflammation in patients with diabetic nephropathy at different stages. Methods Ninety patients with type 2 diabetes who were hospitalized at the Department of Endocrinology, Meizhou People's Hospital from July 2015 to December 2017 were selected, and they were divided into three groups according to 24-hour urinary albumin excretion rate (UAER): normal albuminuria group (NA group, UAER<30 mg/24 h), microalbuminuria group (MA group, 30 mg/24 h≤UAER<300 mg/24 h), and clinical nephropathy group (CN group, UAER≥300 mg/24 h). At the same time, we randomly selected 30 patients who underwent physical examination as a normal control group (NC group). Then, the three groups of diabetes patients were randomly and equally divided into an observation group and a control group using a random number table. The control group was given conventional treatment. The observation group was given 0.45 g lipoic acid for injection plus 0.9% sodium chloride injection 250 mL by slow intravenous infusion, once a day for 2 weeks. The changes of UAER, serum creatinine (SCr), blood glucose, hs-CRP, and TNF-α levels were observed. Results The levels of serum hs-CRP and TNF-α in the three groups of patients with type 2 diabetic nephropathy were significantly higher than those in the NC group [(5.98±1.54) mg/L, (6.49±1.84) mg/L, (7.02±1.75) mg/L vs (2.95±0.86) mg/L, F=15.63, P<0.01; (17.19±5.05) ng/L, (19.61±5.42) ng/L, (20.25±6.23) ng/L vs (10.24±3.16) ng/L, F=25.22, P<0.01]; however, there was no significant difference among the three groups of patients with type 2 diabetic nephropathy. The levels of hs-CRP, TNF-α, SCr, and UAER were decreased significantly after lipoic acid treatment in the observation groups than in the control groups [(5.01±0.93) mg/L vs (3.89±0.72) mg/L, (5.51±1.23) mg/L vs (4.25±0.88) mg/L, (6.15±1.32) mg/L vs (4.78±1.01) mg/L, t=3.689, 3.227, 3.192, P<0.05; (15.59±4.19) ng/L vs (12.04±3.45) ng/L, (18.02±4.42) ng/L vs (14.43±4.22) ng/L, (18.67±4.88) ng/L vs (15.09±4.47) ng/L, t=2.526, 2.275, 2.095, P<0.05; (83.5±9.4) μmol/L vs (67.3±6.2) μmol/L, (85.6±16.0) μmol/L vs (61.3±16.7) μmol/L, (98.5±20.4) μmol/L vs (69.4±16.8) μmol/L, t=5.572, 4.069, 4.265, P<0.05; (16.5±7.4) mg/24 h vs (13.3±6.2) mg/24 h, (145.6±66.0) mg/24 h vs (106.3±56.7) mg/24 h, (805.5±166.4) mg/24 h vs (612.3±110.8) mg/24 h, t=5.597, 2.051, 3.742, P<0.05]. Conclusion The inflammatory reaction exists in type 2 diabetic nephropathy patients. Lipoic acid can protect the kidney by improving the inflammatory state of type 2 diabetic nephropathy, reducing urinary microalbumin excretion, and lowering serum creatinine levels. Key words: Lipoic acid; Diabetic nephropathy; Inflammatory factors; Hypersensitive C-reactive protein; Tumor necrosis factor alpha

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