Early Diabetic Nephropathy Group Research Articles

Choroidal structural changes in patients with early diabetic nephropathy

PurposeTo determine alterations of the choroidal thickness (CT) and the choroidal vascularity index (CVI) in patients with glomerular hyperfiltration, a marker of early diabetic nephropathy (DN). MethodsTwenty-two patients with type 2 diabetes (T2D) with glomerular hyperfiltration (early DN group) and 28 patients with T2D without DN (NDN group) were included in the study. Patients with diabetic retinopathy were excluded. Parameters including subfoveal CT, the subfoveal choroidal vascularity index (CVI), and total CVI were measured using spectral-domain enhanced depth imaging optical coherence tomography method. ResultsThe early DN group included 22 patients and the NDN group comprised 28 patients. The groups were similar in terms of age and sex (p>0.05). The CT values were statistically significantly lower in the early DN group than in the NDN group (p < 0.001). There was no significant difference between the early DN group and the NDN group in terms of total and subfoveal CVI (p>0.05). ConclusionThe choroidal thickness decreased in patients with T2D with glomerular hyperfiltration, but there were no differences in CVI when they were compared with patients with T2D without DN.

The diagnostic value of lipoprotein-associated phospholipase A2 in early diabetic nephropathy.

The aim of this study was to investigate diagnosis of lipoprotein-associated phospholipase A2 (Lp-PLA2) in early diabetic nephropathy (DN). A total of 342 type 2 diabetes mellitus (T2DM) patients hospitalized in department of metabolism and nephrology in our hospital from January 2019 to December 2019 were randomly selected. Patients were divided into three groups via urine albumin level: diabetes mellitus (DM) group, simple diabetes group (114 patients, urinary albumin creatinine ratio (UACR)<30 mg/g); DN1 group, early DN group (114 patients, UACR: 30-300 mg/g); DN2 group: clinical DN group (114 patients, UACR > 300mg/g). Eighty healthy adults were examined at the same time. Lp-PLA2, fasting blood glucose (FBG), creatinine (Cr), triglyceride (TG), total cholesterol (TCHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), haemoglobin A1c (HbA1c), blood urea nitrogen/creatinine (BUN/Cr), estimated glomerular filtration rate (eGFR), 24-h urine protein, albumin and creatinine of all subjects were detected and compared. Pearson's correlation analysis and multiple ordered logistic regression were used to investigate the correlation between serum Lp-PLA2 level and DN. The possibility of Lp-PLA2 in the diagnosis of early DN was studied by using the subject working curve. Lp-PLA2 level in DN1 and DN2 groups was significantly higher than that in DM group, with statistical difference (p<.05). With the progression of DN, the level of Lp-PLA2 gradually increased p<.05. Lp-PLA2 was positively correlated with FBG, TG, LDL and HbA1c (R=0.637, p<.01; R=0.314, p=.01; R=0.213, p=.01; R=0.661, p≤.01), was negatively correlated with HDL (r=-0.230, p<.01). The results showed that Lp-PLA2 was an independent factor in the evaluation of early DN. The area under the curve for the evaluation of serum Lp-PLA2 level in early DN was 0.841, the optimal critical value was 155.9 ng/mL, the sensitivity was 88% and the specificity was 76.2%. Lp-PLA2 is an independent factor for the evaluation of early DN, and can be used as an important potential specific indicator for the diagnosis of early DN, meanwhile monitoring the progression of DN.

Renal ectopic lipid deposition in rats with early-stage diabetic nephropathy evaluated by the MR mDixon-Quant technique: association with the expression of SREBP-1 and PPARα in renal tissue.

Renal ectopic lipid deposition (ELD) plays a significant role in the development of diabetic nephropathy (DN). This study aimed to use the magnetic resonance (MR) mDixon-Quant technique to evaluate renal ELD and its association with the expression of sterol regulatory element binding protein 1 (SREBP-1) and peroxisome proliferator-activated receptor alpha (PPARα) in renal tissue. Seventy male Sprague-Dawley (SD) rats were randomly divided into experimental (n=50) and control groups (n=20). A high-fat diet combined with low-dose streptozotocin (STZ) was administered to the experimental group to establish a type 2 diabetes mellitus (T2DM) model. The rats received renal mDixon-Quant scans and blood lipid and histopathological examinations in batches after the T2DM model was established. According to the histopathological findings, the included rats were stratified into control and early DN groups. Renal fat fraction (FF), blood lipid level, the ratio of the integrated optical density of intracellular lipid droplets and the total area of all the cells (IOD/TAC), and the expression of SREBP-1 and PPARɑ in renal tissue were analyzed. Compared to the controls, renal FF, IOD/TAC, the expression of SREBP-1 in renal tissue, and serum total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) levels were higher in the early DN group, while the expression of PPARɑ in renal tissue and the high-density lipoprotein (HDL) level were lower (all P values <0.001). Renal FF gradually increased with the progression of disease [r=0.810 (95% CI: 0.675-0.928), P<0.001]. Positive correlations between renal FF and each of the following: TC, TG, LDL, IOD/TAC, and the expression of SREBP-1 [r=0.479 (95% CI: 0.353-0.640, P=0.012), 0.576 (95% CI: 0.283-0.842, P=0.002), 0.441 (95% CI: 0.305-0.606, P=0.021), 0.911 (95% CI: 0.809-0.964, P<0.001) and 0.800 (95% CI: 0.640-0.910, P<0.001), respectively] and negative correlations between renal FF and each of the following: HDL and the expression of PPARɑ [r=-0.611 (95% CI: -0.809 to -0.469, P=0.001) and -0.748 (95% CI: -0.886 to -0.585, P<0.001), respectively] were found. Renal lipid deposition evaluated by the MR mDixon-Quant technique is associated with the blood lipid level, histological fat quantification, and the expression of SREBP-1 and PPARɑ in renal tissue. The renal FF value might serve as a biomarker for better understanding of renal lipid metabolism in early-stage DN.

Optical Coherence Tomography Angiography Biomarkers in Thai Patients With Diabetic Nephropathy: A Diabetic Eye and Kidney Diseases (DEK-D) Study.

To identify optical coherence tomography angiography (OCTA) biomarkers to predict the diabetic nephropathy (DN) and their associations with 24-hour urine albumin levels in diabetic patients. This cross-sectional, observational study examined 186 eyes from 93 individuals subdivided into three groups according to 24-hour urine albumin levels: no DN, early DN, and late DN. Vessel density (VD), fractal dimension, foveal avascular zone area, intercapillary area, central retinal thickness, and subfoveal choroidal thickness were measured from OCTA images to determine their association with the DN stages. VD values of the superficial capillary plexus, deep capillary plexus, and whole retina were significantly lower in the early DN group compared to the no DN group (adjusted P = 0.042, 0.016, and 0.008, respectively). VD values for the deep capillary plexus and whole retina were significantly decreased in the late DN group compared to the no DN group (adjusted P = 0.025 and 0.021, respectively). Mean fractal dimension, intercapillary area, foveal avascular zone area, central retinal thickness, and subfoveal choroidal thickness were not statistically different among the three groups. VD may be a useful parameter for the early non-invasive screening of DN. Further studies in larger populations are needed to establish a cutoff value for detection. This study investigated the association of each retinal vasculature measurement by OCTA and diabetic nephropathy status which could serve as an alternative way to screen for albuminuria.

Relationship Between Postprandial Blood Glucose, Fasting Insulin, and Glycated Hemoglobin Levels and Early Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus

Objective: To investigate the relationship between postprandial blood glucose (PBG), fasting insulin (FINS), and glycated hemoglobin (HbA1c) levels and early diabetic nephropathy in patients with type 2 diabetes. Methods: 96 cases of type 2 diabetes mellitus treated in our hospital from May 2021 to May 2022 were selected as the research subjects. The patients were divided into two groups according to the urinary albumin excretion rate (UAER), with 53 cases in the type 2 diabetes group (UAER &lt; 30 ?g/min) and 43 cases in the early diabetic nephropathy group (30 ?g/min ? UAER &lt; 300 ?g/min). PBG, FINS, and HbA1c levels were detected in 87 healthy patients. Results: The levels of PBG, FINS, and HbA1c in the early diabetic nephropathy group were higher than those in the control group (P &lt; 0.01) and the type 2 diabetes group (P &lt; 0.01). Conclusion: PBG, FINS, and HbA1c are factors affecting the occurrence of diabetic nephropathy in patients with type 2 diabetes; thus, controlling the levels of PBG, FINS, and HbA1c can effectively prevent the occurrence of diabetic nephropathy in type 2 diabetes mellitus.

Gut microbial products valerate and caproate predict renal outcome among the patients with biopsy-confirmed diabetic nephropathy.

Valerate and caproate are two subtypes of short-chain fatty acids produced by gut microbiota. We aimed to measure the serum valerate and caproate levels and analyze the associations between them and renal prognosis of diabetic nephropathy (DN). The serum samples of patients with biopsy-confirmed diagnosis of DN were collected in the First Affiliated Hospital of Zhejiang University, from April 1, 2013, to March 31, 2018. One hundred patients were included and divided into an early DN group (eGFR ≥ 60ml/min, n = 42) and an advanced DN group (eGFR < 60ml/min, n = 58). The valerate and caproate were measured using gas chromatography-mass spectrometry. Participants were followed up until the cutoff date of August 31, 2018, or if they met the primary endpoint of end-stage renal disease (ESRD). There were 71 males and 29 females in this study, and 29 patients developed ESRD. We observed a significant lower concentration of valerate and caproate in the advanced DN group. There were negative correlations between valerate and glomerular classification (r = - 0.20, P = 0.03) and between caproate and interstitial fibrosis and tubular atrophy (IFTA) (r = - 0.24, P = 0.01). And there were positive correlations between valerate or caproate and eGFR (r = 0.22, P = 0.02; r = 0.38, P < 0.01). Multivariate Cox analysis revealed higher levels of valerate and caproate were negatively related to progression to ESRD (HR = 0.024, P = 0.016; HR = 0.543, P = 0.030). The area under the curve values of valerate and caproate levels were 0.66 and 0.63, respectively, in predicting progression to ESRD. This study showed alterations in serum valerate and caproate in DN and demonstrates lower valerate and caproate levels with progression of DN to ESRD.

Brachial-Ankle Pulse Wave Velocity as a Novel Modality for Detecting Early Diabetic Nephropathy in Type 2 Diabetes Patients.

Brachial-ankle pulse wave velocity (baPWV) has been shown to correlate with a host of disorders associated with arterial stiffness. Type 2 diabetes is associated with the involvement of both small vessels and large vessels. Studies on the relevance of baPWV to early diabetic nephropathy are scarce. This retrospective observational case-control study enrolled 120 patients with type 2 diabetes from our medical records. We classified patients into two groups depending on the magnitude of albuminuria: 60 patients with microalbuminuria were classified as the early diabetic nephropathy group (EDN group) and 60 patients without albuminuria were classified as the diabetes without nephropathy group (DWN group). An additional 30 nondiabetic age- and sex-matched controls were also enrolled. Data regarding the lipid profile, blood pressure, baPWV, high-sensitivity C reactive protein (hs-CRP) level, anthropometric measurements, urine albumin/creatinine ratio (UACR), serum creatinine level, and glycemic control indices (i.e., fasting plasma glucose (FPG), postprandial glucose (PPG), and glycosylated hemoglobin (hemoglobin A1c, HbA1c)) were recorded for all enrolled participants. baPWV was significantly higher in the EDN group than in the DWN group. Moreover, baPWV was positively correlated with age, duration of diabetes, obesity, poor glycemic control, and high serum levels of triglycerides (TG), hs-CRP, creatinine, and uric acid as well as a high UACR (all P < 0.01). A significant negative correlation was found between baPWV and high-density lipoprotein levels (P < 0.05). Multivariate regression analysis showed that the hs-CRP level and duration of diabetes most strongly influenced baPWV. baPWV may be a convenient, noninvasive, and reproducible method for detecting early diabetic nephropathy.

Value Analysis of the Combined Detection of Cystatin C, Hypersensitive C-reactive protein and Urinary Microalbumin in the Diagnosis of Early Renal Damage in Diabetes

To explore the value of combined detection of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the diagnosis of early diabetic renal damage. From September 2016 to May 2018, 96 patients with type 2 diabetes were selected and divided into three groups according to the staging criteria of renal damage caused by diabetes: simple diabetes group (32 cases), early diabetic nephropathy group (32 cases) and clinical diabetic nephropathy group (32 cases). Another 32 healthy people in the same period were selected as the control group. Fasting venous blood and urine were collected to detect microalbuminuria, urine microalbuminuria, serum cystatin C and hypersensitive C-reactive protein. The sensitivity and specificity of three detection indexes were analyzed by receiver operating characteristic curve. Compared with the control group, the levels of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the simple diabetic group, the early diabetic nephropathy group and the clinical diabetic nephropathy group were significantly increased (p<0.05); the levels of cystatin C, high sensitivity C-reactive protein and microalbuminuria in the early diabetic nephropathy group and the clinical diabetic nephropathy group were significantly higher than those in the simple diabetic group (p<0.05).In the early diabetes group, the positive rates of cystatin C, high sensitivity C-reactive protein and microalbuminuria were lower than those of combined detection, and the difference was statistically significant (p<0.05). Receiver operating characteristic curve analysis showed that the Area under the curve of microalbuminuria, whole blood high sensitivity C-reactive protein, serum cystatin C and diagnosis of early diabetic nephropathy were 0.960, 0.934 and 0.929 respectively, with high accuracy. The AUC of combined detection of the three indicators was 0.994, with sensitivity and specificity of 100.00 % and 99.70 %. The combined detection of high sensitivity C-reactive protein, microalbuminuria and serum cystatin C can improve the sensitivity and specificity of diagnosis of early diabetic nephropathy, which is of great significance for clinical prevention and treatment of early diabetic nephropathy and progression to end-stage renal disease.

Relationships between diabetic nephropathy and insulin resistance, inflammation, Trx, Txnip, CysC and serum complement levels.

To investigate the relationships between diabetic nephropathy (DN) and insulin resistance, inflammation, thioredoxin (Trx), thioredoxin-interacting protein (Txnip), Cystatin C (CysC) and serum complement levels. A total of 119 patients with type 2 diabetes mellitus (T2DM) treated in the Endocrinology Department of our hospital from January 2017 to December 2017 were enrolled as the experiment group, while 30 healthy volunteers were selected as the control group. The expression levels of inflammatory factors, Trx, Txnip, CysC and serum complements in every subject were detected. In addition, the type 2 diabetic nephropathy rat model was established via high-fat diet and injection of low-dose streptozotocin. Blood glucose, insulin resistance indexes and 24h-urinary albumin excretion were measured, and the histomorphological characteristics of the kidney in animals were observed. In clinical subjects, Trx level was notably lower in the simple DM group, early DN group and clinical DN group in comparison with that in the control group. The levels of Txnip and CysC in the simple DM group, early DN group and clinical DN group were remarkably higher than those in the control group. Moreover, the expression levels of TNF-α and IL-6 in the clinical DN group were significantly elevated compared with those in the simple DM group and early DN group. In addition, C1q expression in the clinical DN group was higher than that in the simple DM group and early DN group. In model rats, HOMA-IR was distinctly higher in the DM group and DN group than that in the control group. The ratio of kidney weight to body weight (KW/BW) was evidently higher in the DN group in comparison with that in the control group and DM group. Insulin resistance, inflammatory factors, and levels of Trx, Txnip, CysC and serum complement C1q are related to the progression of DM.

Noninvasive evaluation of early diabetic nephropathy using diffusion kurtosis imaging: an experimental study.

To evaluate the value of renal diffusion kurtosis imaging (DKI) in the diagnosis of early diabetic nephropathy (DN) in a rat model. Forty male Zucker diabetic fatty rats that spontaneously developed type 2 diabetes mellitus (DM) and 20 age-matched nondiabetic lean Zucker rats were included. Renal DKI scans and histological examinations were performed on the rats in batches at the end of the 4th, 8th, 12th, 16th, and 20th week after DM model was built. Based on renal histopathological appearance, included animals were divided into three groups: a nondiabetic control group, a DM group without DN, and an early DN group. Mean kurtosis (MK) and mean diffusivity (MD) values of renal cortex and medulla were analyzed statistically. MK values of renal cortex and medulla tended to increase from the control group to the early DN group, respectively, while MD values tended to decrease. The cutoff MD and MK values of renal cortex and medulla showed different values in discriminating early DN from controls. Among them, cutoff MK value of medulla of 0.62 was the best parameter (sensitivity, 93.9%; specificity, 96.4%; and area under the curve, 0.95). For discriminate early DN from DM without DN and DM without DN from controls, cutoff MK value of renal cortex or medulla achieved an area under the curve of 0.76-0.85. MR DKI may be valuable for the noninvasive detection of early DN, and MK value might serve as a more sensitive biomarker of early DN than MD value. • In this article, diffusion kurtosis imaging (DKI) was used to detect the changes in the kidneys due to early diabetic nephropathy (DN). • MR DKI may be valuable for the noninvasive detection of early DN. • The mean kurtosis values of renal cortex and medulla might serve as a more sensitive biomarker of early DN than the mean diffusivity values.

Clinical application of urinary microalbumin/creatinine in random urine screening in patients with early diabetic nephropathy

Objective To determine the diagnosis value of urinary albumin(mAlb)/creatinine(Ucre) ratio in random urine from patients with early diabetic nephropathy. Methods From March 2015 to December 2016, 98 case with simple diabetes and early diabetic nephropathy in Ankang Hospital of Traditional Chinese Medicine were selected, including 47 cases with simple diabetes and 51 cases with early diabetic nephropathy.And 60 healthy people were selected as control group.The mAlb and mAlb/Ucre ratios in morning urine, postprandial urine and random urine were detected for three times in three days, and the resluts were calculated and analyzed. Results In early diabetic nephropathy group, the mAlb concentration varied during different time periods, mAlb in morning urine[(60.5±27.1)mg/L]and postprandial urine[(60.7±26.7)mg/L]were significantly increased compared with that in random urine[(40.9±25.1)mg/L](F=9.551, P=0.000). The MAlb/Ucre ratios were stable in morning urine, postprandial urine and random urine of each period (P>0.05). The positive rate of mAlb/Ucre ratio was sharply higher than mAlb alone in random urine (90.2% vs.62.7%). No statistically significant difference showed in positive rates of mAlb/Ucre ratio in subjects from different groups(the positive rate of morning urine specimen was 92.2%; postprandial urine 88.2%; random urine 90.2%, P>0.05). Conclusion Positive rate of mAlb/Ucre ratio changed slightly during different test periods, and is superior to mAlb alone in clinic application.Additionally, the positive rate of mAlb/Ucre ratio in random urine could serve as an indicator in early screening of early diabetic nephropathy. Key words: Albuminuria; Urinary creatinine; Urinalysis; Diabetic nephropathies

Study on the relationship between the methylation of the MMP-9 gene promoter region and diabetic nephropathy.

This study aims to explore the relationship between the methylation of matrix metalloproteinase (MMP)-9 gene promoter region and diabetic nephropathy (DN) through the detection of the methylation level of MMP-9 gene promoter region in the peripheral blood of patients with DN in different periods and serum MMP-9 concentration. The methylation level of the MMP-9 gene promoter region was detected by methylation-specific polymerase chain reaction (MSP), and the content of MMP-9 in serum was determined by enzyme-linked immunosorbent assay (ELISA). Results of the statistical analysis revealed that serum MMP-9 protein expression levels gradually increased in patients in the simple diabetic group, early diabetic nephropathy group and clinical diabetic nephropathy group, compared with the control group; and the difference was statistically significant (P < 0.05). Compared with the control group, the methylation levels of MMP-9 gene promoter regions gradually decreased in patients in the simple diabetic group, early diabetic nephropathy group, and clinical diabetic nephropathy group; and the difference was statistically significant (P < 0.05). Furthermore, correlation analysis results indicated that the demethylation levels of the MMP-9 gene promoter region was positively correlated with serum protein levels, urinary albumin to creatinine ratio (UACR), urea and creatinine; and was negatively correlated with GFR. The demethylation of the MMP-9 gene promoter region may be involved in the occurrence and development of diabetic nephropathy by regulating the expression of MMP-9 protein in serum.

The clinical significance of TNFR1 and TNFR2 in early diabetic nephropathy of type 2 diabetes

Objective To explore the relationship of serum tumor necrosis factor receptor 1 (TNFR1), and TNFR2 with early diabetic nephropathy in type 2 diabetes patients. Methods A total of 70 patients with type 2 diabetes and 35 healthy person were selected from December 2013 to November 2014 in the Fifth Hospital of Datong, the urinary albumin excretion rate (UAER) was determined, and were divided into three groups: normal control group (n=35), simple diabetes group (n=35), and early diabetic nephropathy group (n=35). Enzyme-linked immuno sorbent assay (ELISA) method was used to determine TNFR1 and TNFR2. Results Compared to normal control group[TNFR1 (302.5±60.0)pg/ml, TNFR2 (62.1±9.8)pg/ml], simple diabetes group[TNFR1 (515.1±78.1)pg/ml, TNFR2 (178.5±38.9)pg/ml], and early diabetic nephropathy group[TNFR1 (1 066.8±205.6)pg/ml, TNFR2 (279.6±37.1)pg/ml]were all increased; and early diabetic nephropathy group was higher than simple diabetes group (P<0.05). The levels of TNFR1 and TNFR2 were positively correlated with age, course, glycated hemoglobin (HbA1c) levels(P<0.01), and were negatively correlated with high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) (P<0.01). The multiple stepwise regression analysis in eGFR had significant effects on TNFR 1 and TNFR 2 levels (P<0.01). Conclusions The levels of TNFR1, and TNFR2 in early diabetic nephropathy were increased. TNFR1 and TNFR2 may become new markers to evaluate early diabetic nephropathy. Key words: Receptors, tumor necrosis factor/ME; Diabetic nephropathies/ME

Correlation between cognitive impairment and diabetic nephropathy in patients with Type 2 diabetes mellitus

To explore the correlation between diabetic nephropathy (DN) and cognitive impairment through examining the cognitive function and the metabolism of the cerebrum in Type 2 diabetes mellitus patients at different stages of renal function. Eighty six patients with Type 2 diabetes mellitus (T2DM) were enrolled for this study. According to the urinary albumin excretion rate (UAER), the patients were divided into a T2DM without DN group (DM group, n=33), an early DN group (DN-III group, n=26) and a clinical stage group (DN-IV group, n=27). Thirty healthy adults were selected as a control group (NC group). Biochemical indexes and UAER were measured, and glomerular filtration rate (GFR) was detected by single-photon emission computed tomography (SPECT). The cognitive function was measured by Montreal Cognitive Assessment (MoCA, Beijing version) and mini-mental state examination (MMSE). The peak areas of N-acetylasparte (NAA), creatine (Cr), choline-containing compounds (Cho) were detected by proton magnetic resonance spectroscopy (1H-MRS). 1) There was no statistical difference in MMSE scores between the DM group and the control group. The scores of MoCA in the DN-III group or in the DN-IV group were significant less than that in the NC group (F=3.66, P<0.05); 2) There was significant difference in left N-acetylaspartate (LNAA), left choline (LCho) among the diabetes groups. Compared with the DM group, the level of LNAA was decreased significantly (t=3.826, P<0.05) while the LCho was increased significantly (t=4.373, P<0.05) in the DN groups, with statistic difference between the 2 groups (t=3.693, P<0.05); 3) The MoCA scores of T2DM patients were negatively correlated with UAER (r=-0.285, P<0.05), while positively correlated with GFR (r=0.379, P<0.05); 4) Logistic regression analysis indicated that UAER and GFR were the major risky factors for diabetic cognitive impairment. Diabetic cognitive impairment is closely correlated with the nephropathy in patients with Type 2 diabetes. With the decline in glomerular filtration function, the cognitive disorder tends to be aggravated. The hippocampal brain metabolism may have some changes in left side of Cho/Cr in patients with diabetic nephropathy.

Correlation of Arterial stiffness and early renal damage in patients with type 2 diabetes mellitus

Objective To investigate the relationship between early diabetic nephropathy and arterial stiffness in patients with type 2 diabetes mellitus. Methods The clinical data of one hundred twenty patients with T2DM were collected for retrospective study. The patients with T2DM were divided into an early diabetic nephropathy group (Group A)and a non-early diabetic nephropathy(Group B)according to the albuminuria to creatinine ratio(ACR)of first morning urine. Then compared the difference of the arterial stiffness between the two groups. Results An independent-sample T test was used for analysis. The brachial-ankle pulse wave velocity(baPWV)in group A and group B was(1 827.3±450.2)cm/s and(1 634.5±285.8)cm/s,respectively, which was statistically significance(t=2.164,P <0.05). Logistic regression analysis, in which baPWV was regarded as dependent variable, while age,blood pressure, ACR, and blood urea nitrogen(BUN)were independent variables, showed that age,systolic pressure, ACR,and BUN had an influence on the result of baPWV. Conclusion The patients with T2DM with arterial stiffness are prone to early diabetic nephropathy. Therefore, dectection of arterial stiffness maybe an effective measure to evaluate the renal function of patients with T2DM, and make an intervention as soon as possible. Key words: Diabetes mellitus, type 2; Arterial stiffness; Renal injury; Albuminuria; Creatinine

Influence of experimental early diabetic nephropathy on the functional subtypes of renal α1‐adrenoceptor in spontaneously hypertensive rats (SHR)

This study investigated the impact of early diabetic nephropathy (EDN) on the functional population of renal α1‐adrenoceptors in SHR rats. One week after streptozotocin, EDN was confirmed by hyperglycemia (14.8±2.3 vs 5.7 ±0.6 mg/dL), raised creatinine clearance (4.2±0.10 vs 0.5±0.07 mL/min/100g), albumin‐creatinine ratio (94.6±3.7 vs 39.4±2.6 µg albumin/mg creatinine) and fractional excretion of Na+ (1.2±0.01 vs 0.4±0.01 %) compared to non‐diabetic (NDN) rats. In acute studies, renal vasoconstrictions caused by renal nerve stimulation and intrarenal noradrenaline, phenylephrine and methoxamine were determined in the presence and absence of intrarenal amlodipine (AMP), 5‐methylurapidil (MEU), chloroethylclonidine (CEC) and BMY 7378. In both NDN and EDN rats, the renal vasoconstrictions were attenuated by all antagonists (AMP‐ NDN, 5‐15% and EDN, 8‐20%; MEU‐ NDN, 5‐14% and EDN, 9‐14%; BMY 7378‐ NDN, 5‐10% and EDN, 5‐8%). CEC enhanced these responses in EDN (5‐10%) but did not cause any effect in NDN SHR rats. The data showed that α1A and α1D are the renal functional α1‐adrenoceptors in SHR rat irrespective of the presence of EDN. A minor contribution of pre‐synaptic α1B‐adrenoceptors was observed in the EDN group.