Albuminuria In Diabetic Patients Research Articles

Correlation between serum ferritin and proteinuria as marker of diabetic nephropathy stage in type 2 diabetic patients

Background: Increased iron reserves in the body have been linked to the development of type 2 diabetes, as well as diabetic nephropathy, retinopathy and vascular dysfunction. Serum ferritin has been related to the occurrence of CKD. Aim of study: Aiming to look into the link between serum ferritin and proteinuria as a diabetic nephropathy marker in type 2 diabetic patients. subjects and methods: It involved 50 individuals of the same age and gender who were split into two groups: 25 type 2 diabetic patients with proteinuria and 25 apparently healthy volunteers (hospital personnel) with no history of diabetes who served as the control group. The Enzyme-linked immunosorbent assay (ELIZA) kit for quantitative detection of human serum ferritin was used to estimate serum ferritin. Results: In the current study, serum ferritin levels in diabetics with proteinuria showed a high significant rise when compared to the control group. (p < 0.001). The comparative present study, the mean ± SD of diabetic patients with nephropathy, serum ferritin was 513.91±260.06 than that of control 133.42±186.66. The current study found a high significant positive relationship between ferritin and 24h protein in diabetic patients with nephropathy(r=0.512, p=0.009), show no significant positive association in control group (r=0.02, p=0.94). Conclusion: serum ferritin can be considered as an independent predicting marker of diabetic nephropathy as well as an excellent diagnostic marker for patients with clinical diabetic nephropathy.

Serum Adenosine Deaminase and C - reactive protein in Diabetic patients with and without Neuropathy

Background: Diabetic Peripheral Neuropathy (DPN) is one major microvascular complication of long-standing diabetes mellitus with a prevalence of 50-60%. DPN leads to decreased quality of life, increased morbidity, and mortality. C reactive protein (CRP) and Adenosine deaminase (ADA) are independent inflammatory markers; the current study aims to evaluate and compare serum ADA, CRP in diabetic patients with and without neuropathy. Materials and Methods: A prospective study was done on 160 diabetic patients with and without neuropathy who visited the Medicine department of Kasturba hospital Manipal. Patients grouped into two, diabetic with neuropathy (n=80) and without Neuropathy (n=80). Serum samples were collected and analysed for CRP and ADA. Results: The data were analyzed using the Independent t-test and Mann-Whitney U test. There was a significantly high level of ADA (p=0.032) in neuropathy patients when compared with the non-DPN group. No significant difference was seen in CRP levels (p=0.123) in DPN patients compared to non-DPN patients. Conclusion: Monitoring of inflammatory markers like ADA in diabetic patients can provide insight into preventing DPN and its associated complications.

Albuminuria and retinal vessel density in diabetes without diabetic retinopathy: the Kailuan Eye Study.

Diabetic retinopathy and chronic kidney disease are both major complications of diabetes mellitus. We explored the relationship between retinal vessel density (VD) and albuminuria in diabetic patients without conventionally defined diabetic retinopathy. The cross-sectional community-based Kailuan Diabetic Retinopathy Study included patients with type 2 diabetes without diabetic retinopathy who participated in the community-based longitudinal Kailuan study and who had undergone ocular fundus photography, kidney function assessment, and optical coherence tomographic angiography (OCT-angiography) for the assessment the retinal perfusion density (PD) and retinal VD. The study included 447 patients (mean age: 60.9±9.7years). Higher PD and VD were associated with a lower urinary albumin-creatinine ratio (uACR) (macular region: p=0.007: standardized regression coefficient beta: -0.14; and p=0.008, beta: -0.13, respectively; parafoveal region: p=0.006, beta: -0.14; and p=0.007, beta: -0.14, respectively) after adjusting for age and ocular axial length. In a reverse manner, higher uACR was associated with lower PD and VD (macular region: p=0.009, beta: -0.14; and p=0.01, beta: -0.14, respectively; parafoveal region: p=0.008, beta: -0.14; and p=0.01, beta: -0.14, respectively), after adjusting for diabetes duration, blood pressure, serum concentration of C-reactive protein and high-density lipoprotein cholesterol and ocular axial length. In a multivariable model, the prevalence of macroalbuminuria increased by 11% (95% CI: 2%, 18%) and 17% (95% CI: 3%, 30%), respectively, for each mm-1 decrease in VD and each unit decrease in PD. After adjusting for systemic and ocular parameters, diabetic patients without diabetic retinopathy showed a reduction in OCT-angiographic retinal vascular measurements in association with systemic parameters indicating chronic kidney disease. Optical coherence tomographic (OCT)-angiographic retinal microvascular parameters may serve as markers for chronic kidney disease.

Relationship between carotid atheroma thickness and albuminuria in diabetic patients

&nbsp; Our aim in this study to assess the efficacy of albuminuria in type 2 diabetes mellitus to be as predictor and independent marker of atherosclerosis by measurement of carotid intimal-medial thickness (CIMT)&nbsp; by high frequency ultrasonography. One hundred twenty participants in this study, 45 as a control healthy person and the others 75 patients with type 2 diabetes mellitus were included in this study. We divided into three groups: group 1 which is the control group, and group 2 those patients who are the diabetic without albuminuria, and group 3 are the diabetic patients with albuminuria. The intimal-medial thickness (IMT) was measured by high frequency ultrasonography. Other laboratory investigations were measured like HbA1c, fasting blood sugar, lipid profile. The intimal-medial thickness (IMT) was found higher in group 3 than group 1 and group 2 (P value &lt; 0.05). In conclusion, there is a significant association between micro- albuminuria and IMT as a marker of atherosclerosis in type 2 diabetes mellitus.

The Survey of Relationship Between Resistance Index of Renal Artery and Albuminuria in Diabetic Patients Referring to Shahid Sayyad Shirazi Hospital, 2017 to 2018

Introduction. The Resistance Index by doppler ultrasound has been characterized as a non-invasive diagnostic method that has been well predictive of the outcome of renal function in type 2 diabetic patients. This study aims to investigate the relationship between renal artery resistance index (RI) and albuminuria in diabetic patients. Methods. This descriptive, analytical, cross-sectional study was conducted on diabetic patients referred to the clinic for ultrasonography. Patients were divided into two groups: macro albuminuria and microalbuminuria or normoalbuminuria and for all patients, ultrasonography was done using the same ultrasound machine and by the same operator. Doppler sonography of the renal arteries was performed and the results were recorded. Results. 52.4% of the patients were female. The mean age of these patients was 50.25 ± 16.41. The mean RI in the study population was 66.0 ± 0.01. In this study, RI with albuminuria and HbA1c levels in diabetic patients were not significant. However, there was a significant relationship between RI and serum creatinine in diabetic patients, with increasing creatinine level, RI was also increased. Also, there was a significant relationship between RI and gender and this indicator had a direct relation with male gender but there was no correlation with female gender. Conclusion. In the current study, the patient’s albuminuria, type of treatment and HbA1c had no effect on the RI. The study also found that an increase in the RI index could be a significant predictor of renal dysfunction and increased creatinine.

The effect of Aqueous, Ethanolic extracts of Rheum ribeson insulin sensitivity, inflammation, oxidative stress in patients with type 2 diabetes mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial

Type 2 diabetes mellitus, one of the most common chronic metabolic disorders, occurs when the body is unable to utilize insulin effectively. Hyperglycemia, one of the most common characteristics of diabetes, is related to the development of several diabetic adverse effects, which lead to an elevation in oxidative stress and inflammation responses. Among the current therapeutic options, such as hypoglycemic drugs and insulin therapy, which have limitations, there has been much attention given to the use of traditional medicinal plant that modulate hyperglycemia, inflammation, improve oxidative stress, and prevent diabetes-induced complications. Therefore, the aim of the current study is to investigate whether the consumption of aqueous and ethanolic Rheum extractions improve insulin sensitivity, inflammation and oxidative status in subjects with T2DM. Sixty patients with T2DM (male and female) were recruited in this double-blind, randomized and controlled clinical trial from the Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran. The participants were randomly allocated into three groups aqueous extract (n = 20), ethanolic extract (n = 20) and control (n = 20) who were given three Rheum ribes capsules daily for 6 weeks. A significant elevation in the quantitative insulin-sensitivity check index (QUICKI) was observed at the end of study in the aqueous extracts (P = 0.03) and also ethanolic extracts (P = 0.01) of Rheum extract groups compared to initial values. At the end of study, there was also a significant reduction in levels of malondialdehyde (MDA) in ethanolic extracts (P = 0.002) compared to initial values; however, intervention with aqueous extracts had no effect on malondialdehyde. There was also a significant reduction of high sensitivity C-reactive protein in ethanolic extracts (P = 0.001) and aqueous extracts (P = 0.001) groups at the end of study compared to initial values. At the end of the study, there were significant differences in the insulin, ethanolic extract group compared to control group. It appears that the ethanolic extract is more effective than the aqueous extract of Rheum ribes in diabetic patients. Rheum ribes intake may have favorable effects on insulin sensitivity, malondialdehyde and high sensitivity C-reactive protein in diabetic patients.

Interleukin-6, Tumor Necrosis Factor-α, and High-sensitivity C-reactive Protein in Diabetic Patients with Helicobacter pylori in Kosovo

Helicobacter pylori is a Gram-negative spiral-shaped bacterium that infects from 30% to 50% of the world’s population and it is one of the most important in dyspeptic syndrome causes of gastritis and peptic ulcer. H. pylori is one of the most common chronic bacterial infections especially in the development countries because the socioeconomic contribute to chronic disease. The infection induces an acute polymorphonuclear infiltration in the gastric mucosa. Infection with H. pylori has been epidemiologically linked to some extra digestive conditions, including ischemic heart disease, diabetes mellitus (DM), and others. The patients with DM are at risk for H. pylori infection, since they have coupled susceptibility of to a wide range of infections as a result of chronic elevation of blood glucose level and impairment of immune functions. Chronic inflammation is a risk factor for coronary heart disease, because inflammation, vascular injury and thrombosis are considered to cause atherosclerosis. The risk of cardiovascular events is associated with increased levels of the acute phase proteins, C-reactive protein (CRP), and pro-inflammatory cytokines. Interleukin 6 (IL-6), a major pro-inflammatory cytokine is produced in a variety of tissues, including activated leukocytes, adipocytes, and endothelial cells. CRP is the principal downstream mediator of the acute phase response and is primarily derived through IL-6-dependent hepatic biosynthesis. Tumor necrosis factor-α (TNF-α), as an important inflammatory factor, has been shown to play a central role in the pathogenesis of diabetes. CRP and IL-6 were determinant of risk for the development of type 2 DM in apparently healthy middle-aged women. Since the prevalence of infected persons with H. pylori in Kosovo is high, the aim of this study was the evaluation of cytokines (IL1, TNF-α) and CRP in diabetic type 2 patients with positive H. pylori.

The Effects of Different Quantities and Qualities of Protein Intake in People with Diabetes Mellitus.

The recommended amount and quality of protein in diets of diabetic patients are highly controversial. In order to provide evidence-based information, the Diabetes Nutrition Study Group (DNSG) used a grading procedure used for quality of evidence and strength of recommendations (GRADE). A protein intake of 10% to 20% of energy intake (E%) or about 0.8 to 1.3 g/kg body weight in people below 65 years of age, and 15% to 20% of E% in people above 65 years of age appeared safe in weight-stable conditions. There were no intervention studies addressing metabolic effects, mortality, or cardiovascular events over prolonged periods. Body weight is closely linked to metabolic control and high protein diets are often recommended. Weight-loss diets that include 23% to 32% of E% as protein for up to one year reduced blood pressure and body weight slightly but significantly more than lower protein diets, whereas blood lipids, fasting blood glucose, and HbA1c improved similarly with higher or lower protein intakes in participants with a glomerular filtration rate (GFR) >60 mL/min/1.73 m2. Patients with a GFR <60 mL/min/1.73 m2 did not show a faster decline of GFR or kidney function with protein intakes around 0.8 g/kg body weight as compared with lower intakes, thereby arguing against a restriction. The effects of protein intake on diabetic eye or nerve disease have not been reported. There are a number of studies that have compared different types of animal proteins (milk, chicken, beef, pork, and fish) or compared animal with plant protein in diabetic patients and have reported a greater reduction of serum cholesterol with plant protein. In summary, the suggested range of protein intake appears to be safe and can be adapted according to personal dietary preferences.

Can a semi-quantitative method replace the current quantitative method for the annual screening of microalbuminuria in patients with diabetes? Diagnostic accuracy and cost-saving analysis considering the potential health burden.

ObjectivesDiabetes is a global epidemic, and the high cost of annually and quantitatively measuring urine albumin excretion using the turbidimetric immunoassay is challenging. We aimed to determine whether a semi-quantitative urinary albumin-creatinine ratio test could be used as a screening tool for microalbuminuria in diabetic patients.MethodsWe assessed the diagnostic accuracy of the semi-quantitative method. The costs of false results in the semi-quantitative method were calculated based on the annual probability of disease progression analyzed through a systematic literature review and meta-analysis. The pooled long-term cost-saving effect of the semi-quantitative method compared with the quantitative test was assessed using a Markov model simulating a long-term clinical setting. Diagnostic accuracy and the cost-saving effect were also validated in an independent external cohort.ResultsCompared with the quantitative test, the semi-quantitative method had sensitivities of 93.5% and 81.3% and specificities of 61.4% and 63.1% in the overall sample of diabetic patients (n = 1,881) and in diabetic patients with eGFR ≥60 ml/min/1.73 m2 and a negative dipstick test (n = 1,110), respectively. After adjusting for direct and indirect medical costs, including the risk of disease progression, which was adjusted by the meta-analyzed hazard ratio for clinical outcomes, it was determined that using the semi-quantitative method could save 439.4 USD per person for 10 years. Even after adjusting the result to the external validation cohort, 339.6 USD could be saved for one diabetic patient for 10 years.ConclusionsThe semi-quantitative method could be an appropriate screening tool for albuminuria in diabetic patients. Moreover, it can minimize the testing time and inconvenience and significantly reduce national health costs.

Arctigenin attenuates diabetic kidney disease through the activation of PP2A in podocytes

Arctigenin (ATG) is a major component of Fructus Arctii, a traditional herbal remedy that reduced proteinuria in diabetic patients. However, whether ATG specifically provides renoprotection in DKD is not known. Here we report that ATG administration is sufficient to attenuate proteinuria and podocyte injury in mouse models of diabetes. Transcriptomic analysis of diabetic mouse glomeruli showed that cell adhesion and inflammation are two key pathways affected by ATG treatment, and mass spectrometry analysis identified protein phosphatase 2 A (PP2A) as one of the top ATG-interacting proteins in renal cells. Enhanced PP2A activity by ATG reduces p65 NF-κB-mediated inflammatory response and high glucose-induced migration in cultured podocytes via interaction with Drebrin-1. Importantly, podocyte-specific Pp2a deletion in mice exacerbates DKD injury and abrogates the ATG-mediated renoprotection. Collectively, our results demonstrate a renoprotective mechanism of ATG via PP2A activation and establish PP2A as a potential target for DKD progression.

The effect of A1 adenosine receptor in diabetic megalin loss with caspase-1/IL18 signaling.

PurposeIn our previous study, exacerbation of albuminuria was observed in A1 adenosine receptor knockout (A1AR−/-) mice with diabetic nephropathy (DN), but the mechanism was unclear. Here, we investigated the relationship of megalin loss and albuminuria, to identify the protective effect of A1AR in megalin loss associated albuminuria by inhibiting pyroptosis-related caspase-1/IL-18 signaling of DN.MethodsWe successfully collected DN patients' samples and built diabetes mice models induced by streptozotocin. Megalin, cubilin, and A1AR expression were detected in kidney tissue samples from DN patients and mice through immunohistochemical and immunofluorescent staining. A1AR, caspase-1, interleukin-18 (IL-18) expression were analyzed using Western blotting in wild-type and A1AR−/- mice. Human renal proximal tubular epithelial cells (PTC) were cultured with high glucose to observe the effect of A1AR agonist and antagonist on caspase-1/IL-18 and megalin injury.ResultsThe loss of megalin, co-localized with A1AR at PTC, was associated with the level of albuminuria in diabetic patients and mice. The injury of megalin-cubilin was accompanied with the A1AR upregulation (1.30±0.1 vs 0.98±0.2, P=0.042), the caspase-1 (1.33±0.1 vs 1.0±0.2, P=0.036), and IL-18 (1.26±0.2 vs 0.96±0.2, P=0.026) signaling activation in mice with DN. More severe pathological injury, 24 hrs urine albumin excretion (170.8±4.1 μg/d vs 132.0±2.9 μg/d vs 17.9±2.8 μg/d, P<0.001) and megalin-cubilin loss were observed in A1AR−/- DN mice with more pronounced caspase-1 (1.52±0.03 vs 1.20±0.01, P=0.017) and IL-18 (1.42±0.02 vs 1.21±0.02, P=0.018) secretion. High glucose could stimulate the secretion of caspase-1 (1.72 times, P≤0.01) and IL-18 (1.64 times, P≤0.01), which was abolished by A1AR agonist and aggravated by A1AR antagonist.ConclusionA1AR played a protective role in proximal tubular megalin loss associated albuminuria by inhibiting the pyroptosis-related caspase-1/IL-18 signaling in DN.

Association of urinary monocyte chemoattractant protein-1 (MCP-1) and kidney injury molecule-1 (KIM-1) with risk factors of diabetic kidney disease in type 2 diabetes patients.

Urinary kidney injury molecule-1 and monocyte chemoattractant protein-1 are significance factors in the diagnosis and intervention of diabetic kidney diseases. This study determined levels of these proteins in diabetic patients with varying degrees of kidney disease and assessed their relationship with risk factors associated with diabetic kidney diseases. A total of 185 patients with type 2 diabetes were divided into three groups [low risk (n = 47), moderate risk (n = 63), and high risk (n = 75)] based on the severity of diabetic kidney disease according to kidney disease: improving global outcomes guidelines. Both urinary kidney injury molecule-1 and monocyte chemoattractant protein-1 levels were measured by enzyme-linked immunosorbent assay. Student`s t test, analysis of variance, and Spearman's correlation were used for statistical analysis. The kidney injury molecule-1-to-creatinine ratio (P = 0.035) and monocyte chemoattractant protein-1-to-creatinine ratio (P < 0.001) increased significantly with the increase in kidney disease severity and varied according to different albuminuria statuses and estimated glomerular-filtration rates. The monocyte chemoattractant protein-1-to-creatinine ratio showed a significant correlation with hemoglobin A1c (P = 0.002) and inflammatory marker levels (interleukin-6, P = 0.005; tumor necrosis factor-α, P < 0.001). Urinary levels of both kidney injury molecule-1 and monocyte chemoattractant protein-1 represent distinguishing markers for the evaluation of diabetic kidney disease progression according to the associated degrees of albuminuria or/and the estimated glomerular-filtration rate. In addition, correlations between urinary monocyte chemoattractant protein-1 and glycemic and inflammatory marker levels revealed the role of hyperglycemia and chronic inflammation in the pathogenesis of diabetic kidney disease.

513-P: Adenosine Signal Plays an Important Role in Renoprotective Effects of SGLT2 Inhibitor in Proteinuric Diabetic Mice

Background: SGLT2 inhibitor (SGLT2i) displayed remarkable and early renal protection in overt nephropathy cases in clinical trials. However, detailed molecular mechanisms by which SGLT2i ameliorated renal damage in proteinuric diabetic patients were not elucidated yet. Here, we investigated that SGLT2i exerted renal protective effects via adenosine signal in diabetic mice with overt proteinuria. Methods: STZ (200mg/kgBW) was injected intraperitoneally to induce diabetes in 8-week-old CD-1 mice. Four weeks later, mice were treated with intraperitoneal injection of bovine serum albumin (BSA: 0.3g/30gBW) with or without oral administration of SGLT2i TA-1887 (30mg/kg). Result: In the STZ+BSA, pronounced renal tubular damages and interstitial fibrosis were observed; TA-1887 significantly ameliorated. The mRNA microarray analysis of kidney samples revealed that gene expressions related to TGF-β signaling pathway and epithelial-mesenchymal-transition program were increased in the STZ+BSA compared to the Control+BSA; TA-1887 suppressed them. Furthermore, the expression of ecto 5'-nucleotidase (5'-NT), which is essential for production of adenosine from AMP, was suppressed in STZ+BSA compared to Control+BSA; TA-1887 restored 5’-NT levels. In the immunohistological analysis, 5'-NT was expressed in glomeruli including mesangial cells and renal tubules of cortex/medulla in control kidney. However, 5’-NT was suppressed in all areas of STZ+BSA kidney; TA-1887 reversed the 5'-NT expression and distribution. Glomerular filtration rate (GFR) evaluated by inulin clearance was significantly greater in the STZ+BSA group and suppressed by TA-1887; the administration of the adenosine type 1 receptor inhibitor, DPCPX, cancelled the effects of TA-1887 on GFR and renal tubule damage. Conclusion: The adenosine signal plays an important role in the renal protective effects of SGLT2i in diabetic mice with proteinuria. Disclosure K. Shimada: None. Y. Takagaki: None. K. Kanasaki: Other Relationship; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Mitsubishi Tanabe Pharma Corporation, Ono Pharmaceutical Co., Ltd., Sanofi, Taisho Toyama Pharmaceutical. D. Koya: Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Self; Astellas Pharma Inc., Astellas Pharma Inc., AstraZeneca, Merck &amp; Co., Inc., Mitsubishi Tanabe Pharma Corporation, Taisho Pharmaceutical Co., Ltd. Funding Japan Society for the Promotion of Science

Correlation Between Serum PON1 Arylesterase Activity and Rs 854573 &amp;lt;i&amp;gt;PON1 A &amp;lt; G&amp;lt;/i&amp;gt; Polymorphism with Type 2 Diabetes in an Eastern Indian Cohort

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder of glucose and lipids and characterized by defect in insulin secretion or action. Oxidative imbalance has also been implicated in the etiology of diabetes. Paraoxonase-1 (PON1) is an esterase and lactonase which is found in the circulation bound to high-density lipoproteins (HDL). Alterations and associations of circulating PON1 levels with a variety of diseases including diabetes encourages us to investigate the possible association between PON1 A/G rs854573 polymorphism and serum PON1 activity with T2DM. The study essentially follows a population based case-control format with 101 diabetic and 102 healthy controls. The findings revealed association of polymorphism with the diseased status (p value 0.0002, OR 3.49, 95% CI 1.77 to 6.9). With significantly higher range of mean serum PON1 Arylesterase (AREase) activity in control (9.99 – 0.96 kU/L) than in diabetic patients (5.25 - 0.508 kU/L) (p value,<0.001), a large difference between common diabetic AA genotype and combined diabetic heterozygous and homozygous genotypes (AG+GG) for risk allele G (assymptometic p value,<0.001), or in between two AA genotypes (Diabetic/Non diabetic, p<0.001), was explored by parametric and non parametric statistical pairwise comparison. Serum PON1 activity was found to be independent of other clinical factors such as plasma glucose levels. Western blot analysis of serum samples detected a significant difference of PON1 proteins in diabetic patients and control subjects (p value 0.008). In conclusion serum PON1 AREase activity which to an extent correlated with PON1 promoter polymorphism might be a good predictor of the disease risk.

Relationship of vitamin D level and microalbuminuria in type 2 diabetic patients

Background Great prevalence of patients with type 2 diabetes mellitus (T2DM) has been witnessed in the last decades worldwide. The global prevalence has been estimated to reach 6.4% among adults at the beginning of the current decade. Diabetic nephropathy is considered the most common complication that affects the kidney and plays as a leading cause of end-stage kidney disease. The presence of proteinuria in diabetic patients is a sign of risk. Vitamin D is a multitrait steroid hormone involved in a wide spectrum of cell regulatory and metabolic functions. Multiple diseases were observed to be frequently associated with low levels of vitamin D. Objective To estimate the level of vitamin D in T2DM patients, to assess its relation to microalbuminuria, and to estimate the effect of vitamin D replacement on these patients. Patients and methods A case–control study was conducted on 50 T2DM patients having microalbuminuria (group 1), 50 T2DM patients with no microalbuminuria (group 2), and 50 apparently healthy persons (group 3) (the control group), Routine tests such as complete blood count, fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin’, liver enzyme tests [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], kidney function tests (urea, creatinine), lipid profiles [cholesterol, Triglyceride (TG)], serum albumin, calcium, phosphorus, intact parathyroid hormone (PTH), 25-hydroxycholecalciferol in the blood, and urinary albumin/creatinine ratio were done. Results The study showed highly statistically significant decrease of vitamin D level in group 1 (diabetes with microalbuminuria) compared with group 2 (diabetes without microalbuminuria) and group 3 (control) (P&lt;0.001). A statistically significant negative correlation was found between microalbuminuria and vitamin D (r=−0.946). It also showed a highly statistically significant decrease of microalbuminuria after treatment with vitamin D compared with before treatment. There was a highly statistically significant decrease of glycosylated hemoglobin after vitamin D replacement. Conclusion This study demonstrated that vitamin D was significantly deficient in diabetic patients in comparison with the control group and it is significantly deficient in T2DM with microalbuminuria compared with T2DM without microalbuminuria. It showed that microalbuminuria was significantly improved after treatment with vitamin D but not to nonmicroalbminuric level. These findings indicated that there is a potential role of vitamin D in diabetic nephropathy pathogenesis.

The Relationship Between Taurin, Glycated Hemoglobın And C- Reactive Protein In Diabetic Patients With Heart Surgery

The Relationship Between Taurin, Glycated Hemoglobın And C- Reactive Protein In Diabetic Patients With Heart Surgery

Corrigendum to "Expression of Duodenal Iron Transporter Proteins in Diabetic Patients with and without Iron Deficiency Anemia".

[This corrects the article DOI: 10.1155/2018/7494821.].

Nephrotic range proteinuria; does it predict lung involvement in patients with type 2 diabetes

BackgroundDiabetes mellitus is a chronic metabolic disorder that is well known for its long term serious complications. Proteinuria whether micro or macroproteinuria is one of these complications. Many studies has related proteinuria to other complications of diabetes as retinopathy and cardiovascular disease of diabetes, while the lungs of diabetic patients which is the largest organ in the body with a large macro and microvascular bed, has not been related to this complication. AimThe aim of the study was to find out whether proteinuria in diabetic patients can predict lung involvement. Patients and methodsA comparative cross sectional study in which we compared the lung function of 100 type 2 diabetic patients with proteinuria with that of 100 type 2 diabetic patients without proteinuria. Proteinuria is measured in a random sample by “urine protein/urine creatinine ratio”. FEV1 and FVC were measured by spirometer. ResultsThe results showed that patients with proteinuria had a high frequency of abnormal PFT (86%), while patients without proteinuria had a low frequency of abnormal PFT (11%).Also diabetic patients with proteinuria had lower FVC (72.9 ± 6.5 vs. 88.2 ± 8.2), than diabetic patients without proteinuria. ConclusionsWe concluded that diabetes mellitus causes a significant impairment in pulmonary function test. This impairment is significantly related with proteinuria.

Expression of Duodenal Iron Transporter Proteins in Diabetic Patients with and without Iron Deficiency Anemia.

The role of iron transport proteins in the pathogenesis of anemia in patients with diabetes mellitus (T2DM) is still unclear. We investigated the expression of duodenal transporter proteins in diabetic patients with and without iron deficiency anemia (IDA). Methods. Overall, 39 patients were included: 16 with T2DM and IDA (group A), 11 with T2DM without IDA (group B), and 12 controls (group C). Duodenal mucosal expression of divalent metal transporter 1 (DMT1), ferroportin 1 (FPN), hephaestin (HEPH), and transferrin receptor 1 (TfR) was evaluated by Western blotting. Chronic disease activity markers were measured as well. Results. FPN expression was increased in group A compared to group B and controls: 1.17 (0.72–1.46), 0.76 (0.53–1.04), and 0.71 (0.64–0.86), respectively (p = 0.011). TfR levels were over expressed in groups A and B compared to controls: 0.39 (0.26–0.61), 0.36 (0.24–0.43), and 0.18 (0.16–0.24), respectively, (p = 0.004). The three groups did not differ significantly with regard to cellular HEPH and DMT1 expression. The normal CRP and serum ferritin levels, accompanied with normal FPN among diabetic patients without IDA, do not support the association of IDA with chronic inflammatory state. Conclusion. In patients with T2DM and IDA, duodenal iron transport protein expression might be dependent on body iron stores rather than by chronic inflammation or diabetes per se.

Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients: A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial).

URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00794885.