Risk Factor For Diabetic Nephropathy Research Articles

Smoking and diabetic nephropathy: An updated systematic review and meta-analysis.

Several studies have reported the potential association between smoking and diabetic nephropathy. However, the studies of non-significant association results were against the association between smoking and diabetic nephropathy. Therefore, the relationship between smoking and diabetic nephropathy was still debated and controversial. Prospective cohort studies were included in the current meta-analysis. The tobacco smoking (current smokers or former smokers) and non-smoking groups in the enrolled studies were compared for the hazard ratio (HR) of diabetic nephropathy. Fifteen studies with 221,821 subjects were included in this meta-analysis. Subgroup analysis of the type 1 diabetes and type 2 diabetes groups was also performed individually to investigate the effects of different types of diabetes on the relationship between smoking and diabetic nephropathy. Current smoking was significantly associated with a greater log HR of diabetic nephropathy [1.44 (1.22-1.70), Z = 4.39]. In addition, former smoking was significantly associated with diabetic nephropathy [log HR = 1.04 (1.03-1.05), Z = 8.02]. The individual subgroup analysis of type 1 diabetes and type 2 diabetes subjects showed that smoking might be both significantly associated with greater log HRs of diabetic nephropathy. Current and former smoking might be the risk factors for diabetic nephropathy in the current meta-analytic results. The phenomenon of such significant associations were discovered in type 1 and 2 diabetes.

Systemic immune-inflammation index as an independent risk factor for diabetic nephropathy: a retrospective, single-center study.

Systemic immune-inflammation index (SII) was an indicator which could reflect immune response and systemic inflammation. We aim to explore the relationship between SII and diabetic nephropathy (DN). SII was calculated as neutrophil count × platelet count/lymphocyte count. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnosis power of SII. Univariate and multivariate logistic analysis were conducted to assess SII as the risk factor for DN. A restricted cubic spline model was carried out to show the nonlinear association between SII and DN. Two hundred participants were enrolled, with an average age of 56.6 ± 13.4 years; 54% participants were categorized as DN. Spearman association analysis showed SII was positive associated with increased urinary albumin to creatinine ratio and serum creatinine, while negative associated with eGFR and serum albumin. The ROC curve revealed that the maximum area under the curve (AUC) was 0.761 (95% CI, 0.694-0.828, P<0.001). After univariate and multivariate logistic analysis, SII (OR=1.004, P=0.002) and serum creatinine (OR=1.146, P<0.001) were risk factors for the occurrence of DN, while age (OR=0.920, P=0.011) and serum albumin (OR=0.708, P<0.001) were protective factors for the occurrence of DN. The restricted cubic spline model showed that there was a significant nonlinear association between DN incidence and continuous SII value when it exceeded 624*10 9/L. SII is a novel diagnostic biomarker which is independently associated with DN. Further large-scale prospective studies are needed to validate our findings before SII can be considered a reliable diagnostic or prognostic tool for DN.

Glucagon receptor activation contributes to the development of kidney injury.

The underlying causes of diabetic kidney disease are still largely unknown. New insights into the contributing causes of diabetic nephropathy are important to prevent this complication. Hyperglycemia and hypertension are some of the risk factors for diabetic nephropathy. However, the incidence of diabetic nephropathy is increasing despite efforts to normalize blood glucose levels and blood pressure. Therefore, other factors should be investigated as causes of diabetic nephropathy. We investigated whether long-term increased plasma levels of glucagon contribute to the development of pathophysiological changes in kidney function as seen in patients with diabetic nephropathy. Using mouse models of chronic activation and inactivation of glucagon receptor signaling, we investigated whether glucagon is involved in changes in renal function, renal structure, and transcriptional changes. We found several histopathological changes in the kidney, such as thickening of the parietal layer of Bowman's capsule, glomerular mesangial cell expansion, and significant albuminuria in the mice with activated glucagon receptor signaling. Opposite effects on mesangial area expansion and the development of albuminuria were demonstrated in mice with glucagon receptor inactivation. RNA sequencing data revealed that transcription of genes related to fatty acid metabolism, podocytes, Na+-K+-ATPase, and sodium/glucose transport was significantly changed in mice with activated glucagon receptor signaling. These data implicate that glucagon receptor signaling is involved in the development of kidney injury, as seen in type 2 diabetes, and that glucagon receptor is a potential therapeutic target in the treatment of diabetes. NEW & NOTEWORTHY This study suggests that the glucagon receptor is a potential therapeutic target in the treatment of diabetic kidney disease. We show, in mice, that long-term treatment with a glucagon analog showed not only pathophysiological changes and changes in renal function but also transcriptional changes in the kidneys, whereas opposite effects were demonstrated in mice with glucagon receptor inactivation. Therefore, the use of glucagon in a treatment regimen requires investigation of possible metabolic and renal abnormalities.

Lipids: A Major Culprit in Diabetic Nephropathy.

The pathophysiology of diabetic nephropathy (DN) is too complex and involves a variety of pathways and mediators. Hyperglycaemia and dyslipidemia are identified as major risk factors for diabetic nephropathy. Various studies revealed the fact that dyslipidemia is a major contributor to the process of diabetic nephropathy. Dyslipidemia refers to abnormal lipid levels. Lipids like LDL, free fatty acids, abnormal lipoproteins, ceramides, etc., are unsafe for kidneys. They target proximal tubular epithelial cells, podocytes, and tubulointerstitial tissues through biochemical changes, especially by enhancing the release of reactive oxygen species (ROS) and lipid peroxidation, endorsing tissue inflammation and mitochondrial damage, which give rise to nephropathy. Major lipid targets identified are SREBP1, LXR, FXR PPAR, CD-36, PKc, AGE/RAGE pathway, and ferroptosis. The drug acting on these targets has shown improvement in DN patients. Various preclinical and clinical studies support the fact that hyperlipidemic agents are promising targets for DN. Therefore, in conjunction with other standard therapies, drugs acting on dyslipidemia can be added as a part of the regimen in order to prevent the incidence of ESRD and CVD.

Evaluation of Common Risk Factors of Diabetic Nephropathy among Diabetic Adults

Background: Diabetic nephropathy (DN) is a specific micro vascular complication of diabetes mellitus (DM), approximately one third of affected diabetic patients eventually develop DN. The level of albuminuria is highly correlated with the intraglomerular pressure which is the key determinant of DN. A number of risk factors were suggested for the development of DN. Objective: To evaluate the common risk factors of diabetic nephropathy and to determine the association of different risk factors with diabetic nephropathy among adult diabetic patients. Methods: This cross-sectional study was conducted at the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of one hundred twenty-eight (128) adult diabetic patients were enrolled. We identified nephropathy among them by doing albumin creatinine ratio (ACR) on spot urine and carried out relevant laboratory investigations. Common risk factors of diabetic nephropathy like- hypertension (HTN), overweight/obesity, family history of HTN/DM/DN, duration of DM, glycated hemoglobin (HbA1C) and dyslipidemia were evaluated accordingly. Result: Among 128 study population, 52 (40.6%) patients were found to have diabetic nephropathy. Of them, 27.3% had microalbuminuria, 13.3% had macroalbuminuria. Hypertension, overweight/obesity, family history of HTN/DM and dyslipidemia were observed to be significantly higher in nephropathy group than those in the non-nephropathy group (p&lt;0.05). Hypertension, dyslipidemia and duration of diabetes mellitus were the independent predictors for diabetic nephropathy. Conclusion: The prevalence of diabetic nephropathy is high (40.6%) among diabetic adults. Several risk factors are significantly associated with diabetic nephropathy. Hypertension, dyslipidemia and duration of diabetes mellitus are the independent predictors for diabetic nephropathy.

The Effect of Selected Nitric Oxide Synthase Polymorphisms on the Risk of Developing Diabetic Nephropathy.

Nitric oxide synthase (NOS) is an enzyme that catalyzes the formation of nitric oxide (NO), the altered production of which is characteristic of diabetic nephropathy. NOS exists in three isoforms: NOS1, NOS2, and NOS3. Moreover, there are reports about the potential role of NOS3 polymorphisms in the development of diabetes complications. The aim of this study was to assess the role of selected NOS polymorphisms-rs3782218 (NOS1), rs1137933 (NOS2), rs1799983, rs2070744, and rs61722009 (NOS3)-in the risk of developing diabetic nephropathy and in the likelihood of renal replacement therapy. The studied polymorphisms were analyzed in a group of 232 patients divided into three groups. Four polymorphisms (rs3782218, rs1137933, rs1799983, rs2070744) were genotyped using the PCR-RFLP, while the rs61722009 polymorphism was genotyped using the PCR. The C/C genotype and the C allele of the rs3782218 polymorphism (NOS1) were associated with an increased risk of developing diabetic nephropathy and an increased likelihood of renal replacement therapy. In turn, the G allele of the rs1137933 polymorphism (NOS2) reduces the likelihood of renal replacement therapy. The specific genotypes or alleles of the rs3782218 (NOS1) and rs1137933 (NOS2) polymorphisms seem to be potential risk factors for diabetic nephropathy and renal replacement therapy.

A Comprehensive Analysis of Risk Factors of Diabetic Nephropathy and Exploring the Treatment Pattern

A Comprehensive Analysis of Risk Factors of Diabetic Nephropathy and Exploring the Treatment Pattern

Determinants of diabetic nephropathy among adult diabetic patients on follow-up at public hospitals in Addis Ababa, Ethiopia: A case-control study.

Diabetic nephropathy is defined as patients with diabetes mellitus who have persistent proteinuria for at least three consecutive measurements per year, a high blood creatinine level (>130 mol/l), or a decrease in glomerular filtration rate (<60 ml/min). Limited studies were done in Ethiopia on determinants of diabetic nephropathy among diabetic patients. Therefore, this study aimed to identify determinants of nephropathy among adult diabetic patients on follow-up at public hospitals in Addis Ababa, Ethiopia, 2022. A hospital-based unmatched case-control study design was conducted from 6 September to 9 November 2022, among diabetic patients on follow-up at public health hospitals in Addis Ababa. Using consecutive sampling techniques, a total of 442 (353 controls and 89 cases) were recruited, with a control-to-case ratio of 4:1. The data were collected using a structured and interview-administered questionnaire and variables like high-density lipoprotein, low-density lipoprotein, Glycated hemoglobin, and type of diabetes were extracted from the medical records of the patients using a checklist. The collected data were entered into Epidata 3.1 and analyzed by STATA version 15.0. Variables with a p-value < 0.25 in the bivariable logistic regression were selected for the final model. In multivariable logistic regression model fitting, variables with a p-value < 0.05 with 95% CI adjusted odds ratio have declared statistically significant risk factors of diabetic nephropathy. In this study, out of 442 study participants, 334 controls and 89 cases were included in the analysis, with a response rate of 94.6% and 100%, respectively. The majority of the study participants were 92.13% of cases and 84.13% of controls; 7.87% of cases, and 15.87% of controls were type 2 diabetes mellitus. Age 65 and above years old (AOR: 2.42; 95% CI: 1.28, 4.57); Smoking cigarette (AOR: 2.22; 95% CI: 1.18, 4.16); Non-adherent to diet (AOR: 2.11; 95% CI: 1.15, 3.84); Drinking alcohols (AOR: 1.95; 95% CI: 1.07, 3.52); Duration with diabetes more than 10 years (AOR: 3.39; 95% CI: 1.76, 6.54); Poor glycemic control (AOR: 2.19; 95% CI: 1.23, 4.28); and Low-density lipoprotein (AOR: 2.97; 95% CI: 1.69, 5.28) were found to be statistically significant risk factors of nephropathy among diabetic patients. This study found that old age, smoking cigarettes, non-adherence to diet, duration of diabetes, alcohol drinking, Glycated hemoglobin A1C, and high low-density lipoprotein were risk factors for nephropathy. Hence, continuous health education on lifestyle modifications and diabetic-related complications in each follow-up visit via front-line health professionals are very essential to avert the problem.

Prevalence and Risk Factors of Diabetic Nephropathy Among Saudi Type-1 Diabetic Patients in Taif City, Saudi Arabia

Prevalence and Risk Factors of Diabetic Nephropathy Among Saudi Type-1 Diabetic Patients in Taif City, Saudi Arabia

Type 2 diabetes clusters in the Novosibirsk region

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a heterogeneous disease. Determination of different T2DM phenotypes will improve the prediction of metabolic disorders, the risk of complications and individual diabetes therapy.AIM: To identify clusters of T2DM in patients with different duration of diabetes with a study of the frequency of diabetic complications and drug therapy in the Novosibirsk region.MATERIALS AND METHODS: The study was carried out at Diamodul in the period 2013–2017 in the Novosibirsk region. K-means cluster analysis was performed in 2805 T2DM patients aged 44 to 75 years with a duration of diabetes of 7.84±6.53 years based on 5 variables — HbA1c, age at diagnosis, BMI, C-peptide, sex.RESULTS: Cluster analysis identified three clusters: cluster 1 in 1003 patients (35.7%) with preserved β-cell function, age of T2DM diagnosis 51.72±8.29 years and BMI 33.50±5.74 kg/m2, in men there was a 27% higher risk of developing diabetic nephropathy compared to women. Cluster 2 in 432 patients (15.4%) with increased function of β-cells, the age of diagnosis of T2DM was older — 52.91±7.75 years, patients had a higher BMI of 35.64±7.21 kg/m2 and more high diastolic blood pressure, earlier development of diabetic retinopathy, nephropathy and polyneuropathy, and better response to metformin therapy and combined therapy with metformin and sulfonylurea. Cluster 3 in 1370 patients (48.8%) with reduced function of β-cells, the age of diagnosing T2DM was younger — 49.63±8.32 years, patients had a lower BMI of 33.09±6.36 kg/m2 and had longer diabetes, high fasting glucose levels, males were associated with a higher risk of developing diabetic nephropathy (by 26%) compared with women, the first line of therapy was insulin therapy in 52.8% of patients.CONCLUSION: The conducted study in T2DM patients with different duration of diabetes confirmed the possibility of using cluster analysis to identify phenotypes of T2DM in the Russian population by five variables (HbA1c, age at the time of diagnosis, BMI, C-peptide, gender). A high incidence of early development of diabetic polyneuropathy, nephropathy and retinopathy was revealed in a cluster with increased function of β-cells, male gender was risk factor for diabetic nephropathy and polyneuropathy.

Clinical Analysis of Diabetic Nephropathy Risk Factors and Correlation with Blood Pressure Control

Objective: To explore the risk factors of diabetic nephropathy and its correlation with blood pressure control. Methods: A retrospective analysis of 80 patients with diabetic nephropathy (diabetic nephropathy group) and another 80 patients with diabetes (diabetic group) who were admitted to the Department of Nephrology and Endocrinology at our hospital from October 2021 to October 2022 was conducted. The general data of the two groups were compared, the influencing factors associated with the two groups were analyzed unilaterally, and unconditional dichotomous logistic regression was performed to analyze the influencing factors in patients with diabetic nephropathy. Results: There were no significant differences in high-density lipoprotein, systolic blood pressure, diastolic blood pressure, and creatinine between the two groups (P &gt; 0.05); however, compared with the diabetic group, the DN group had significantly elevated glycated hemoglobin, low-density lipoprotein, 24-h urine protein, insulin resistance, and diabetes duration ? 10 years (P &lt; 0.05). Conclusion: The clinical research on the correlation between the incidence of hypertension and the control of blood pressure in patients with diabetic nephropathy should be strengthened in order to formulate reasonable and feasible treatment plans.

Comparative estimation of proteinuria using spot urine albumin creatinine ratio and 24 hour urine protein among diabetics for detecting nephropathy

Purpose: Although proteinuria has been established as an independent risk factor of diabetic nephropathy, the timely and accurate estimation of proteinuria has scope for improvement. Hence, this study intends to compare the accuracy of spot sampled urine albumin creatinine ratio (UACR) to 24 hour urine protein among diabetics in the quantification of proteinuria. Design/Methodology/Approach: This prospective study was conducted amongst 120 patients diagnosed with type 2 diabetes mellitus. Two types of urine samples namely spot samples and 24-hour samples were analysed across an array of clinical variables including urine biochemistry, kidney failure and glomerular filtration rate. UACR in spot samples was correlated with the 24-hour urine protein levels. The sensitivity, accuracy, specificity and predictive values of UACR for proteinuria were determined. A p

Nomogram analysis of risk factors for diabetic neuropathy in primary type 2 diabetic mellitus patients in Zhejiang Province

Objective: To investigate the risk factors of diabetic nephropathy (DN) in primary type 2 diabetes mellitus (T2DM) patients and to quantitatively analyze the risk of DN by nomogram modeling. Methods: A total of 1 588 primary T2DM patients from 17 townships and streets in Zhejiang Province were enrolled from June 2018 to August 2018 in this cross-sectional study, with an average age of (56.8±10.1) years (50.06% male) and a mean disease duration of 9 years. The clinical data, biochemical test results, and fundus photographs of all T2DM patients were collected, and logistic regression analysis was used to screen the risk factors of DN. Then, a nomogram model was used to quantitatively analyze the risk of DN. Results: DN occurred in 27.71% (440/1 588 cases) primary type 2 diabetes patients. Hemoglobin A1c (HbA1c) (OR=1.159, 95%CI 1.039-1.292), systolic blood pressure (OR=1.041, 95%CI 1.031-1.051), serum creatinine (Scr) (OR=1.011, 95%CI 1.004-1.017), serum globulin (GLOB) (OR=1.072, 95%CI 1.039-1.105), diabetic retinopathy (DR) (OR=1.463, 95%CI 1.073-1.996), education level of more than junior high school (OR=2.018, 95%CI 1.466-2.777), and moderate-intensity exercise (OR=0.751, 95%CI 0.586-0.961) were influencing factors of DN. Nomogram model analysis showed that the total score of each factor of DN ranged from 64-138 points, and the corresponding risk rate ranged from 0.1-0.9. The nomogram model also predicted a C-index value of 0.753 (95%CI 0.726-0.781) and an area under the receiver operating characteristic curve of DN of 0.753. Internal verification of the C-index reached 0.738. The model displayed medium predictive power and could be applied in clinical practice. Conclusions: HbA1c, systolic blood pressure, Scr, GLOB, DR, and more than a junior high school education are independent risk factors of DN. Nomogram modeling can more intuitively evaluate the risk of DN in primary T2DM patients.

Risk Factors for Diabetic Nephropathy among Newly Detected Type 2 Diabetic Patients Attending a Tertiary Care Hospital of Bangladesh

Background: Patients with type 2 diabetes mellitus may present with different macro- and micro-vascular complications including diabetic nephropathy. This study was designed to evaluate the risk factors for diabetic nephropathy among newly detected type 2 diabetic patients. Methods: This case-control study was done at BIRDEM General Hospital, Dhaka, Bangladesh from January to September 2017. Adult (³18 years), type 2 diabetic patients, who were detected as diabetic for the first time, within the previous three months and who tested, at least, 2 urine samples for urine albumin to creatinine ratio (UACR), at least 6 weeks apart, were consecutively enrolled for the study. Pregnant ladies, patients with diagnosed kidney disease, patients having features of glomerulonephritis and systemic diseases like vasculitis and systemic lupus erythematosus, history of recent fever, urinary tract infection and menstruation were excluded. Patients having UACR ³30 mg/g in at least 2 (out of 3, if tested) samples were taken as cases and those with UACR &lt; 30 mg/g were controls. Data were analyzed by statistical package for social sciences (SPSS) version 20. Results: Total patients were 224 with female predominance (150, 67%). Fifty one (22.8%) patients had diabetic nephropathy (microalbuminuria = 47 and overt proteinuria = 4). Multivariate regression analysis revealed that, hypertension [odds ratio (OR) = 3.71; 95% CI 1.23 to 4.31, p = 0.003], smoking (OR = 3.27; 95% CI 2.91 to 4.79, p = 0.003), family history of diabetes (OR = 2.31; 95% CI 1.84 to 3.14, p = 0.005) and diabetic nephropathy (OR = 3.34; 95% CI 2.40 to 4.97, p = 0.001), dyslipidaemia (OR = 2.31; 95% CI 1.98 to 3.91, p = 0.023), increased body mass index (BMI) (OR = 2.11; 95% CI 1.54 to 4.87, p = 0.001 and high glycated haemoglobin (HbA1c) (OR 3.21; 95% CI 1.71 to 5.97, p = 0.034) were significant risk factors for diabetic nephropathy. Conclusion: One in every five type 2 diabetic patients had diabetic nephropathy during diabetes diagnosis and most patients had microalbuminuria. Hypertension, dyslipidaemia, smoking, family history of diabetes and diabetic nephropathy, increased BMI and high HbA1c were significant risk factors for diabetic nephropathy among newly detected type 2 diabetic patients. J Bangladesh Coll Phys Surg 2023; 41: 15-21

A Project work on Recent approches in the Treatment of Diabetic Nepheropathy

Renal failure is a common long-torm complication of diabetes mellitus. Stages of diabetic nephropathy have been described that characterize its clinical course. Diabetic nephropathy develops secondary to long- changes that damage the glomeruli’s. Therapy that focuses on the control of glomerular pressures and systemic hypertension can slow the progression of proteinuria and deterioration of renal function. Angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers have been demonstrated to be effective in the management of diabetic nephropathy. A systematic approach to the patient with diabetes with help identify those individuals early in the course of disease when proper therapy may be most helpful. Diabetic nephropathy is the leading cause of chronic renal disease and a major cause of cardiovascular mortality. Diabetic nephropathy has been categorized into stages: micro albuminuria and macro albuminuria. The cut-off values of micro- and macro albuminuria are arbitrary and their values have been questioned. Subjects in the upper-normal range of albuminuria seem to be at high risk of progression to micro- or macro albuminuria and they also had a higher blood pressure than normoalbuminuric subjects in the lower norm albuminuria range. Diabetic nephropathy screening is made by measuring albumin in spot urine. If abnormal, it should be confirmed in two out three samples collected in a three to six-months interval. Additionally, it is recommended that glomerular filtration rate be routinely estimated for appropriate screening of nephropathy, because some patients present a decreased glomerular filtration rate when urine albumin values are in the normal range. The two main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Other risk factors are smoking, dyslipidemia, proteinuria, glomerular hyper filtration and dietary factors. Nephropathy is pathologically characterized in individuals with type 1 diabetes by thickening of glomerular and tubular basal membranes, with progressive meningeal expansion (diffuse or nodular) leading to progressive reduction of glomerular filtration surface. Concurrent interstitial morphological alterations and hyalinization of afferent and efferent glomerular arterioles also occur. Podocytes abnormalities also appear to be involved in the glomerulosclerosis process. In patients with type 2 diabetes, renal lesions are heterogeneous and more complex than in individuals with type 1 diabetes. Treatment of diabetic nephropathy is based on a multiple risk factor approach, and the goal is retarding the development or progression of the disease and to decrease the subject's increased risk of cardiovascular disease. Achieving the best metabolic control, treating hypertension (&lt;130/80 mmHg) and dyslipidemia (LDL cholesterol &lt;100 mg/dl), using drugs that block the renin-angiotensin-aldosterone system, are effective strategies for preventing the development of micro albuminuria, delaying the progression to more advanced stages of nephropathy and reducing cardiovascular mortality in patients with diabetes.

The Role of Angiotensinogen rs699 in Diabetic Nephropathy Among Type 2 Diabetes Mellitus Patients with Uncontrolled Postprandial Glucose Levels

Diabetic Nephropathy (DN) is the most common complication of Type 2 Diabetes Mellitus (T2DM), leading to the highest mortality rate of DM complications. However, its etiology is still questionable. Hyperglycemia, hypertension, and particular genetic susceptibility are associated with DN. Not all patients with uncontrolled hyperglycemia suffer DN. Thus, genetic susceptibility may be a risk factor for DN. The genetic variant of angiotensinogen rs699 is known to be associated with the risk of DN with inconsistent results between ethnicities. This study aims to reveal the correlation between the AGT rs699 with the incidence of diabetic nephropathy among type-2 diabetes mellitus patients with uncontrolled postprandial glucose levels in the Jambi Malay ethnicity. This study was observational analytic research with a cross-sectional design. It used 48 DNA samples from type-2 diabetes mellitus patients with uncontrolled postprandial glucose levels. The authors took 24 DNA samples from patients with DN and 24 without DN (as a control group). The genotyping method used ARMS-PCR specific for AGT rs699. Subjects with the CT genotype had a lower risk for diabetic nephropathy than the CC genotype, but it was not statistically significant (p=0.247; OR=0.508; 95%CI=0.160-1.607). In addition, subjects with the T allele (p=0.331; OR=0.621; 95%CI-0.237-1.630) had a lower risk for diabetic nephropathy than the C allele, but it was not statistically significant. In conclusion, Angiotensinogen rs699 is not a risk factor for diabetic nephropathy among type-2 diabetes mellitus patients with uncontrolled postprandial glucose levels in the Jambi Malay ethnicity.

Epidemiology and Risk Factors of Diabetic Nephropathy in Children and Adolescents

Epidemiology and Risk Factors of Diabetic Nephropathy in Children and Adolescents

Higher serum Sirtuin 1 levels and GA heterozygote of SIRT1 gene polymorphism rs10823108 serve as independent risk factor for diabetic nephropathy in women

IntroductionDiabetic nephropathy (DN) has been one of the most common conditions in patients with type 2 diabetes mellitus (T2DM) and risk of continuous increasing rate of morbidity and mortality worldwide. This study aimed to evaluate the vulnerability of SIRT1 gene polymorphisms with its serum levels in susceptibility to DN and T2DM. MethodsA total of 180 individuals including 60 patients with DN (43 men and 17 women), 60 with T2DM (23 men and 37 women) and 60 healthy controls (24 men and 36 women) were enrolled in age range of 40 to 70 years irrespective of their gender from South Indian population. Venous blood samples was collected from each study participant and used for genotype and allele frequency distribution analysis of rs3818292 and rs10823108 polymorphisms of SIRT1 gene using PCR-RFLP, and estimation of serum Sirtuin 1 levels. ResultsGenotype and allele frequency distribution analysis of rs3818292 polymorphism didn't show significant difference in patients with DN than T2DM. However, rs10823108 polymorphism showed significantly increased (35%) risk of GA genotype in DN women than T2DM (p < 0.05). Although serum Sirtuin 1 levels were significantly higher in both DN and T2DM patients compared to control individuals, no genotype association was observed with both the polymorphisms (p > 0.05). ConclusionGA genotype of rs10823108 polymorphism of SIRT1 gene induces 35% increased risk of DN in women compared to T2DM. Serum Sirtuin 1 levels are increased in DN and T2DM patients than control individuals, no significant association was observed between genotype frequency distribution and Sirtuin 1 levels.

Risk factors for diabetic nephropathy among newly diagnosed type 2 diabetic patients with normal blood pressure

Background: Patients with type 2 diabetes mellitus (T2DM) pass through pre-diabetic stages and during diagnosis, half of them may have different complications including diabetic nephropathy. Hypertension has adverse impacts on diabetic nephropathy. We aimed to evaluate the risk factors for diabetic nephropathy among newly detected T2DM patients with normal blood pressure.&#x0D; Methods: A case-control study was done at a tertiary care hospital in Dhaka, Bangladesh from January 2018 to June 2019. Newly detected (&lt;3 months), adult ( ³18 years), T2DM patients, who underwent tests for urine albumin-to-creatinine ratio (UACR), at least twice, 6-weeks apart, were included in this study. Patients with hypertension, known kidney disease, features of glomerulonephritis, systemic diseases including systemic lupus erythematosus and vasculitis, history of recent fever and exercise, urinary tract infection and pregnancy were excluded. Patients with UACR ³30 mg/g in at least two samples were cases and those with UACR &lt;30 mg/g were controls.&#x0D; Results: Among the total 135 patients, 27 were cases [moderately increased proteinuria (previously, microalbuminuria) (UACR 30–299 mg/g) = 25 and severely increased proteinuria (previously, overt proteinuria) (UACR ³300 mg/g) = 2] and 108 were controls. Multivariate logistic regression revealed that family history of diabetes (OR=2.13; 95% CI, 1.412 to 4.216, p=0.003) and diabetic nephropathy (OR=3.31; 95% CI, 2.145 to 5.249, p=0.001), smoking (OR=3.11; 95% CI, 2.234 to 4.123, p=0.003), dyslipidaemia (OR=2.14; 95% CI, 1.363 to 3.324, p=0.005) and diabetic retinopathy (OR=6.23; 95% CI, 4.197 to 9.464, p=0.004) were significant risk factors.&#x0D; Conclusion: We concluded that, family history of diabetes and diabetic nephropathy, smoking, dyslipidaemia and diabetic retinopathy appeared as significant risk factors for diabetic nephropathy among newly diagnosed T2DM patients with normal blood pressure.&#x0D; BIRDEM Med J 2022; 12(2): 152-157

MO623: Risk Factors of Diabetic Nephropathy Among Newly Detected Type 2 Diabetic Subjects: Preliminary Report from A Tertiary Care Hospital of Bangladesh

Abstract BACKGROUND AND AIMS Patients with type 2 diabetes mellitus may present with different macro- and micro-vascular complications including diabetic nephropathy. This preliminary study was designed to evaluate the risk factors for diabetic nephropathy among type 2 diabetic patients at the time of diabetes diagnosis. METHOD A case-control study was done at a tertiary care hospital in Dhaka, Bangladesh from January to September 2017. Adult (≥18 years), type 2 diabetic patients, who were detected as diabetic for the first time within the previous 3 months and who tested, at least, two urine samples for urine albumin-to-creatinine ratio (UACR), at least 6 weeks apart, within a 6-month period, were consecutively enrolled for the study. Pregnant ladies, patients with diagnosed kidney disease, patients having features of glomerulonephritis and systemic diseases including systemic lupus erythematosus and vasculitis, history of recent fever, urinary tract infection and menstruation were excluded. Patients having UACR ≥30 mg/g in at least two (out of 3, if tested) samples were taken as cases and those with UACR &amp;lt;30 mg/g were taken as controls. Data were analyzed by statistical package for social sciences (SPSS) version 20. RESULTS Total patients were 224 with female predominance (150, 67%). Fifty one (22.8%) patients had diabetic nephropathy (microalbuminuria = 47 and overt proteinuria = 4). Multivariate regression analysis revealed that hypertension {odds ratio (OR) = 3.71 [95% confidence interval (CI) 1.23–4.31], P = 0.003}, smoking [OR = 3.27 (95% CI 2.91–4.79), P = 0.003], family history of diabetes [OR = 2.31 (95% CI 1.84–3.14), P = 0.005] and diabetic nephropathy [OR = 3.34 (95% CI 2.40–4.97), P = 0.001], dyslipidaemia [OR = 2.31 (95% CI 1.98–3.91), P = 0.023], increased body mass index (BMI) [OR = 2.11 (95% CI 1.54–4.87), P = 0.001] and high glycated haemoglobin (HbA1c) [OR 3.21 (95% CI 1.71–5.97), P = 0.034] were significant risk factors for diabetic nephropathy. CONCLUSION Almost 23% of type 2 diabetic patients had diabetic nephropathy during diabetes diagnosis in this study and most patients had microalbuminuria. Presence of hypertension, dyslipidaemia, smoking, family history of diabetes and diabetic nephropathy, increased BMI and high HbA1c were significant risk factors for diabetic nephropathy among patients with type 2 diabetes at diagnosis.