Urine Microalbuminuria Research Articles

Serum Ferritin level, microalbuminuria and non-alcoholic fatty liver disease in type 2 diabetic patients

BackgroundNon-alcoholic fatty liver disease (NAFLD) was considered one of the most common causes of chronic liver disease and is considered the hepatic manifestation of type 2 diabetes mellitus (T2DM). The factors that lead to marked fibrosis and liver cell injury in NAFLD are still remaining undiscovered. Patients and methodsThis study included (40) type 2 diabetic patients with NAFLD and (40) diabetic patients without NAFLD beside 15 healthy persons as a control group. All of them were subjected to full history taking, thorough clinical examination with especial stress on body weight (BW), height, body mass index (BMI), waist-hip ratio, blood pressure. Laboratory tests included serum total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL), fasting blood glucose (FBG) and 2-h postprandial blood glucose (PBG), serum Ferritin and urine microalbuminuria (MAU). ResultsDuration of diabetes, BW, BMI and blood pressure were significantly higher in NAFLD group (P = 0.001). FBG, PBG, TC, TG, LDL, serum Ferritin and MAU were significantly increased in NAFLD group with significant difference between two studied groups as regard HDL. There was a highly significant correlation between serum Ferritin with BW, BMI, duration of diabetes, TC, TG, LDL and MAU. There was a significant correlation between serum Ferritin with age, waist hip ratio, duration of diabetes, SBP, FBG, PBG and HDL. There was a significant correlation between MAU and age, weight, BMI, waist hip ratio, duration of diabetes, DBP, FBG TC, TG, LDL and HDL. ConclusionNAFLD is a common liver disorder in diabetic patients. NAFLD is significantly associated with microalbuminuria and elevated serum Ferritin.

Short-Term Effects of Beraprost Sodium on the Markers for Cardiovascular Risk Prediction in Type 2 Diabetic Patients with Microalbuminuria.

BackgroundTo evaluate the changes in cardiovascular risk markers including pulse wave velocity (PWV), microalbuminuria, inflammatory cytokines, and adhesion molecules after treatment with beraprost sodium (BPS) in patients with diabetic nephropathy.MethodsThis was a multicenter, prospective, randomized, double-blind, placebo-controlled trial. Type 2 diabetes mellitus patients with microalbuminuria were included. The primary endpoints were changes in microalbuminuria in spot urine and PWV after BPS or placebo (PCB) treatment for 24 weeks. The secondary endpoints were changes in clinical and metabolic parameters.ResultsA total of 52 patients completed the 24-week trial. Changes in PWV were not different significantly in the BPS and PCB groups (right, P=0.16; left, P=0.11). Changes in microalbuminuria were 14.2±157.0 and 34.5±146.6 (µg/mg Cr) in the BPS and PCB groups, respectively (P=0.63). Subgroup analysis in the high blood pressure (BP) group (baseline systolic BP >120 mm Hg and diastolic BP >80 mm Hg), showed that microalbuminuria decreased by −47.6 in the BPS group compared with an increase by 116.4 (µg/mg Cr) in the PCB group (P=0.04). Also, in the large waist circumference group (>95 cm), microalbuminuria decreased significantly in the BPS group (P=0.04).ConclusionShort-term treatment of BPS for patients with diabetic nephropathy did not show significant improvement in various cardiovascular risk factors. However, BPS significantly decreased microalbuminuria in study subjects with higher cardiovascular risk such as high BP or large waist circumference.

The Relation between Diabetes Type 1 and 2 Type and Microalbuminuria in Omdurman Teaching Hospital and Altyser Health Center by Using Urine Strip for Microalbuminuria in Sudanese Patients

The present work is Prospective cross sectional study. The main objective is to determine the presence of microalbuminuria in the patients urine in relation to the duration and the age and gender by using urine strip for microalbuminuria. The complications of diabetes mellitus especially end stage renal failure is a major health problem, This study is about the screening diabetic patients for microalbuminuria by simple urine strip for microalbuminuria. During period from Jan. to Aug. 2008, 100 diabetic patients were randomly selected from diabetic clinics of Omdurman Teaching Hospital and Altyser Health Center by using simple direct standardized questionnaire for 100 diabetic patients type I & II. And the urine samples were examined for microalbuminuria Results: out of 100 diabetic patients, 66% were females and 34% were males, type I constitutes about 5 % and type II about 95%, the ages range from (9-90) years. Microalbuminuria detected in about 41% of the patients and 59% had negative results, most of the patients with positive results were in age group (45 -54). The clinical practice in diabetic clinics in Sudan is not following the international guidelines regarding the screening of diabetic nephropathy, so a significant number of the diabetic patients with diabetic nephropathy are missed.

Infusion of autologous bone marrow derived mononuclear stem cells potentially reduces urinary markers in diabetic nephropathy

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Previous studies demonstrated safety and efficacy of autologous bone marrow-derived mononuclear cells (ABM-MNCs) in induced type-1 diabetes mellitus (T1DM) rats. However, the effect of ABM-MNCs on urinary markers of DN in humans is not well studied. We evaluated the therapeutic effect of ABM-MNCs on the urinary markers microalbuminuria (MAU), urinary type-IV collagen and urinary neutrophil gelatinase-associated lipocalin (uNGAL) in T1DM patients with and without nephropathy. This prospective open-label pilot study included 15 patients with T1DM, who had completed 2 visits within 6 months. Patients were divided into two groups according to the presence (DN, n = 7) and absence of nephropathy (T1DM, n = 8). ABM-MNCs were injected at each visit as per study protocol. Routine laboratory data, diabetes tests (fasting serum C-peptide and insulin, glycated hemoglobin, fasting and postprandial glucose), 24-h MAU and urinary type-IV collagen were measured at each visit. uNGAL levels were studied before and after 3days of ABM-MNCs infusion at each visit. Mean age of patients was 29.2 ± 10.4 years, 33% were male, and 27% of the overall group had hypertension. MAU was significantly reduced in the overall group (- 26.0%, p = 0.037), including in DN (- 83.2%, p = 0.021). A short-term significant reduction of uNGAL levels was observed 3days after ABM-MNCs administration during the both the 1st visit (median 13.4 vs. 9.5ng/ml, p = 0.027) and 2nd visit (median 8.8 vs. 6.4ng/ml, p = 0.042) in both groups. However this reduction did not remain significant at the 6-month follow-up. Urinary type-IV collagen did not respond significantly to ABM-MNCs infusion. Infusion of autologous bone marrow-derived mononuclear cells significantly reduced levels of MAU in DN patients. Further studies with larger sample size are needed to confirm these observations.

Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials.

This study evaluated the association of time in range (TIR) of 70-180 mg/dL (3.9-10 mmol/L) with the development or progression of retinopathy and development of microalbuminuria using the Diabetes Control and Complications Trial (DCCT) data set in order to validate the use of TIR as an outcome measure for clinical trials. In the DCCT, blood glucose concentrations were measured at a central laboratory from seven fingerstick samples (seven-point testing: pre- and 90-min postmeals and at bedtime) collected during 1 day every 3 months. Retinopathy progression was assessed every 6 months and urinary microalbuminuria development every 12 months. Proportional hazards models were used to assess the association of TIR and other glycemic metrics, computed from the seven-point fingerstick data, with the rate of development of microvascular complications. Mean TIR of seven-point profiles for the 1,440 participants was 41 ± 16%. The hazard rate of development of retinopathy progression was increased by 64% (95% CI 51-78), and development of the microalbuminuria outcome was increased by 40% (95% CI 25-56), for each 10 percentage points lower TIR (P < 0.001 for each). Results were similar for mean glucose and hyperglycemia metrics. Based on these results, a compelling case can be made that TIR is strongly associated with the risk of microvascular complications and should be an acceptable end point for clinical trials. Although hemoglobin A1c remains a valuable outcome metric in clinical trials, TIR and other glycemic metrics-especially when measured with continuous glucose monitoring-add value as outcome measures in many studies.

A18128 Comparison in the associations of office and ambulatory blood pressures with urinary microalbuminuria in community residents with hypertension

A18128 Comparison in the associations of office and ambulatory blood pressures with urinary microalbuminuria in community residents with hypertension

A2357 A randomized controlled study of the effect of astragalus extract tablets on microalbuminuria in patients with hypertension and metabolic syndrome

Objectives: To investigate the protective effect of Astragalus membranaceus on renal damage in patients with hypertension and metabolic syndrome (MS). Methods: One hundred and nineteen patients of hypertension with MS were randomly divided into control group, Astragalus small dose group and Astragalus large dose group in a randomized controlled clinical study. The control group was given routine medical treatment, Astragalus groups were given astragalus extract tablets for 10 g/d or 5 g/d on the basis of routine medical treatment respectively. Waist circumference, serum glucose and lipid, liver function, renal function, blood pressure, urinary microalbuminuria (MAU) and the levels of asymmetric dimethylarginine were determined at baseline, sixth months and twelfth months respectively. Results: After the treatment of Astragalus membranaceus for twelve months, there was no significant difference between the treatment group and the control group in MS components. The urine microalbuminuria reduced in the high and low dose groups of Astragalus membranaceus after six months (10.79 ± 2.80 VS 11.23 ± 2.99) and twelve months (8.42 ± 2.46 VS 8.61 ± 2.60) (P < 0.05), but the estimated glomerular filtration rate was not changed (P > 0.05); Compared with before treatment, the asymmetric dimethylarginine of high and low dose group of Astragalus membranaceus reduced after twelve months (0.63 ± 0.23 VS 0.63 ± 0.25) (P < 0.05), but the effect was not observed at six months (P > 0.05). Conclusion: The one year use of Astragalus in small doses may play a better role in the protection of renal damage in patients of hypertension with MS.

A study in prevalence of diabetic nephropathy in recently detected cases of type 2 diabetes mellitus as evidenced by altered creatinine clearance, urinary albumin and serum creatinine, with special emphasis on hypertension, hypercholesterolemia and obesity

Background: Diabetic nephropathy is one of the commonest and most dreaded complications of Diabetes. The Aim was to evaluate the significance of microalbuminuria and creatinine clearance for detecting incipient diabetic nephropathy, and to find out the prevalence of nephropathy among freshly detected Type 2 diabetic patients with vs. those without hypertension, hypercholesterolemia and/or obesity.Methods: In this prospective study, 100 recently diagnosed diabetics were studied. Group A had 50 patients with at least one risk factor are hypertension, hypercholesterolemia and obesity. Group B had 50 patients without any of the aforementioned factors. Patients were investigated for presence of Diabetic nephropathy with abnormal serum Creatinine, creatinine clearance and urinary albumin levels.Results: As many as 43 out of 100 patients were found to have Diabetic nephropathy. The number was significantly higher in group A compared to group B (34/50 vs. 9/50). Incidence of nephropathy was higher with higher number of associated risk factors. Urinary microalbuminuria was the commonest abnormality, Serum creatinine was found in only 30.23% of total positive cases.Conclusions: Incidence of diabetic nephropathy is much larger than imagined in freshly diagnosed/new onset cases of DM type 2. Author also conclude that hypertension, obesity and hypercholesterolemia can contribute to development of nephropathy (68% vs. 18% in those who had the factors vs. those who didn’t). Also, urinary microalbuminuria appears to be much more sensitive than serum creatinine as screening tool.

Association of proton pump inhibitor use with the risk of the development or progression of albuminuria among Japanese patients with diabetes: A prospective cohort study [Diabetes Distress and Care Registry at Tenri (DDCRT 16)

AimsWe aimed to determine the prospective association between proton pump inhibitor (PPI) use and the subsequent risk of the development or progression of albuminuria or eGFR. MethodsLongitudinal data of patients with diabetes were obtained from a large Japanese diabetes registry. To assess the independent correlation between PPI use and the development or progression of urine microalbuminuria, the time-varying Cox proportional hazards model was used with adjustment for potential confounders. ResultsThe mean patient age, body-mass index (BMI), and hemoglobin A1c (HbA1c) levels were 65.7 y, 24.5 kg/m2, and 7.5% (57.9 mmol/mol), respectively. In 1711 patients without albuminuria, we observed 599 cases with development of albuminuria over median follow-up of 4.0 years, and in 1279 patients with microalbuminuria, 290 cases with urinary albuminuria progression over 4.0 years, and 257 eGFR decline cases over 3.8 years. PPI use was not associated with the development of albuminuria (HR = 0.88; 95%CI, 0.77–1.01; p = .058), progression of albuminuria (HR = 1.24; 95%CI, 0.87–1.79; p = .236), nor eGFR decline (HR = 1.05; 95%CI, 0.81–1.34; p = .973) even in a propensity score-adjusted model with time-varyingly updating PPI use information. ConclusionsIn conclusion, PPI use was not associated with the subsequent risk of development or progression of albuminuria, or eGFR decline in patients with diabetes.

Porast nivoa mikroalbuminurije uz urinarne enzime kod diabetične bolesti bubrega

Background: Diabetic kidney disease (DKD) is a time progressive problem, give rise in uncontrolled Diabetics increasing risks for chronic kidney disease (CKD) and/or end-stage renal disease (ESRD). The vulnerability to renal dysfunction manifested with sudden glomerular hypofiltration associated with micro-to macroalbuminuria passing to renal failure. So that, screening of specific enzymes shifts, or urinary albumin may predict onset diabetic nephropathy. Objective: The assessment of urinary alkaline phosphatase (ALP), alanine aminopeptidase (AAP), acid phosphatase (ACP) and microalbuminuria (MAU) for type II diabetic patients. Patients and Methods: In this study,120 type II diabetic patients were compared to 90 healthy volunteers of matched age and sex in Al-Leith General Hospital, Al-Leith Kidney Unit (AKU), Al-Leith, Makkah area, KSA in which random urine samples were collected for testing of MAU, ALP, AAP, ACP and Cr. Results: Mean values of measured biomarkers in patient group for MAU, ALP, AAP, ACP and Cr were 51.92 mg/I, 41.55 U/L, 20.17 U/L, 570.10 U/L and 2.92 mg/dl VS in control group were 12.59 mg/I, 8.84 U/L, 6.94 U/L, 385.87U/L and 1.07 mg/dl respectively. Additionally, there were statistically positive correlation between AAP with MAU and ALP; ACP with MAU, ALP and AAP; Cr level with MAU, ALP, AAP and ACP; on the other hand, there were positive significant correlation between duration of diabetes with all studied markers. Conclusion: Using of MAU in addition to other urinary enzymes could be beneficial non-invasive indicators for renal deterioration in type II diabetics.

Link of renal microcirculatory dysfunction to increased coronary microcirculatory resistance in hypertensive patients.

This study investigated the correlation between renal microcirculation and coronary microcirculation in hypertensive patients. Participants consisted of 231 consecutive candidates who were referred to the Second Affiliated Hospital of Wenzhou Medical University from March 2014 to May 2016 for elective coronary angiography due to suspected myocardial ischemia. All participants were evaluated for the index of microvascular resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) us¬ing a pressure wire. Blood and urine samples were collected for determination of the levels of urinary microalbuminuria (mALB), b2-microglobulin (b2-MG), serum cystatin C (CysC), and uric acid (UA). All participants were categorized into two groups according to the renal microcirculatory function. Participants in the observation group had a higher IMR (31 ± 5 vs. 22 ± 6; p < 0.01) and a lower FFR (0.84 ± 0.10 vs. 0.87 ± 0.09 U; p < 0.05) during hyperemia than those in the control group. Linear regression tests revealed that mALB, b2-MG, CysC, and UA levels were positively cor¬related with IMR (r = 0.610, 0.553, 0.701, and 0.647, respectively, p < 0.01). The hs-CRP levels were positively correlated with IMR (r = 0.419, p < 0.01). Multiple regression analysis indicated that renal microcirculation was an independent predictor of IMR. Renal microcirculatory dysfunction in hypertensive patients is characterized by higher IMR and lower FFR; in addition, it is closely correlated with an increased coronary microcirculatory resistance.

Study of Microalbuminuria and hs-CRP in Non-obese and Obese Normotensive and Hypertensive Males and Evaluation of Microalbuminuria and hs-CRP Changes according to the Stages of Hypertension &amp; Grades of Hypertensive Retinal Changes

Aims & Objectives: To measure Microalbuminuria and hs-CRP in obese and non-obese male hypertensive patients and control groups and to correlate their levels with various stages of hypertension and different grades of hypertensive retinal changes. Men have higher prevalence of hypertension (29.4%) than women (26.5%)[1] Materials & Methods: The study was conducted among 60 normotensive individuals and 60 hypertensive individuals over a period of 6 months on OPD basis. All individuals were males in the age group of 40-60 years. Blood samples were collected and estimation of plasma glucose, urea, creatinine, lipid profile, hs- CRP and Urinary microalbumin were done. Results: The mean value of microalbuminuria and hs- CRP were higher among obese hypertensives than obese controls and were statistically significant. The changes in the mean value of microalbuminuria and hs-CRP within the different stages of hypertension were highly significant. Similarly the correlation of microalbuminuria and hs-CRP within the different grades of hypertensive retinal changes were highly significant. Conclusion: The serum level of hs-CRP and urinary microalbuminuria were elevated in hypertensive patients. The increase of both hs- CRP and microalbuminuria were significantly higher in obese hypertensives than non-obese hypertensives. Microalbuminuria & hs CRP levels correlate with various grades of hypertensive retinal changes.

A prospective study on urinary microalbuminuria as surrogate marker of vascular endothelial dysfunction, in patients of ischemic stroke

Background: Presence of overt proteinuria has been independently linked to greater stroke risk. The objectives of this study were to determine the relationship between the for ischemic stroke and albuminurea as a marker for vascular events. Microalbuminuria, is an early marker of both kidney disease and endothelial dysfunction, may be associated with global vascular risk, but the nature and relationship between microalbuminuria and incident ischemic stroke has not been clearly defined. The purpose of this study was to assess the association of microalbuminuria and ischemic stroke.Methods: Study enrolled 150 admitted patients of acute ischemic stroke. The patients were assessed by questionnaire, microalbuminuria, creatinine clearance after detailed history taking and thorough clinical examination.Results: The combined common risk factors were HTN (80%), diabetes (33%) and smoking (53%). The hypertensive patients had 8 times higher risk of microalbuminuria as compared to normotensive patients (95% 1.8-31.0 p&lt;0.05). Among diabetes patients had risk of microalbuminuria 30 times higher compared to euglycemic patients (95% CL 9.6-78.8 p&lt;0.01). The smoker patients had 8 times risk of microalbuminuria (CL 95%-1.2-22.8 p&lt;0.16). However, the patients who had dyslipidemia had risk of microalbuminuria 1.07 times who have normal lipid level, but it was statistically insignificance (98% CL 0.8-4.1 p&gt;0.05). The 38 patients out of 46 patients who had microalbuminuria has high normal serum creatinine with creatinine clearance (45-59 mL/min/1.73 m2. (82% versus. 4.4% 30.44 mL/min/173m2). The risk of microalbuminuria was higher in patients who had high normal serum creatinine (1.4 mg/dL) with creatinine clearance of 45-59 mL/min/1.73 m2 versus normal serum creatinine 0.8 mg/dL.Conclusions: The finding of the study, show the microalbuminuria is an independent risk factor for vascular endothelial dysfunction, in patient of diabetes early renal dysfunction and HTN, extrapolating the vascular event (ischemic stroke).

Indoor air pollution and its association with poor lung function, microalbuminuria and variations in blood pressure among kitchen workers in India: a cross-sectional study

BackgroundThe present study is an attempt to explore the association between kitchen indoor air pollutants and physiological profiles in kitchen workers with microalbuminuria (MAU) in north India (Lucknow) and south India (Coimbatore).MethodsThe subjects comprised 145 control subjects, 233 kitchen workers from north India and 186 kitchen workers from south India. Information related to the personal and occupational history and health of the subjects at both locations were collected using a custom-made questionnaire. Worker lung function was measured using a spirometer. Blood pressure was monitored using a sphygmomanometer. Urinary MAU was measured using a urine analyzer. Indoor air monitoring in kitchens for particulate matter (PM), total volatile organic compounds (TVOC), carbon dioxide (CO2) and carbon monoxide (CO) was conducted using indoor air quality monitors. The size and shape of PM in indoor air was assessed using a scanning electron microscope (SEM). Fourier transform infrared (FTIR) spectroscopy was used to detect organic or inorganic compounds in the air samples.ResultsParticulate matter concentrations (PM2.5 and PM1) were significantly higher in both north and south Indian kitchens than in non-kitchen areas. The concentrations of TVOC, CO and CO2 were higher in the kitchens of north and south India than in the control locations (non-kitchen areas). Coarse, fine and ultrafine particles and several elements were also detected in kitchens in both locations by SEM and elemental analysis. The FTIR spectra of kitchen indoor air at both locations show the presence of organic chemicals. Significant declines in systolic blood pressure and lung function were observed in the kitchen workers with MAU at both locations compared to those of the control subjects. A higher prevalence of obstruction cases with MAU was observed among the workers in the southern region than in the controls (p < 0.01).ConclusionsKitchen workers in south India have lower lung capacities and a greater risk of obstructive and restrictive abnormalities than their north Indian counterparts. The study showed that occupational exposure to multiple kitchen indoor air pollutants (ultrafine particles, PM2.5, PM1, TVOC, CO, CO2) and FTIR-derived compounds can be associated with a decline in lung function (restrictive and obstructive patterns) in kitchen workers with microalbuminuria. Further studies in different geographical locations in India among kitchen workers on a wider scale are required to validate the present findings.

A Study of Correlation of Urine Microalbuminuria and eGFRwith CD4 Count in HIV Patients

A Study of Correlation of Urine Microalbuminuria and eGFRwith CD4 Count in HIV Patients

Cilostazol effectively attenuates deterioration of albuminuria in patients with type 2 diabetes: a randomized, placebo-controlled trial

Cilostazol is an antiplatelet, antithrombotic agent with anti-inflammatory properties. To date, no clinical study has specifically evaluated the efficacy of cilostazol in patients with diabetic nephropathy (DN). We hypothesized that cilostazol might delay renal deterioration in DN patients at high risk of progression. Between April 2008 and April 2010, we screened 156 consecutive patients aged 35–80 years who were first diagnosed with type 2 diabetes after the age of 30 years. Of these, 90 patients with DN, as defined by morning spot urine microalbuminuria (MAU) >20 mg/L or an albumin-to-creatinine ratio (ACR) >30 μg/mg on at least two consecutive occasions within the prior 3 months, were enrolled into a 52-week randomized, single-blinded, placebo-controlled trial of oral cilostazol 100 mg twice daily or placebo (45 subjects in each group). Morning spot urine samples were collected to determine MAU and ACR. Fasting plasma levels of metabolic, endothelial variables, and inflammatory markers were examined. Following 52 weeks of treatment, urinary MAU and ACR were significantly reduced in the cilostazol group compared with the placebo group (P = 0.024 and P = 0.02, respectively). In regression analyses, changes in monocyte chemotactic protein-1, E-selectin, and soluble vascular cell adhesion molecule-1 (sVCAM-1) were significantly associated with changes in MAU and ACR. Net changes of E-selectin (P < 0.001) and sVCAM-1 (P < 0.05) were independent predictors of change in MAU and ACR, respectively. Our results suggest that cilostazol may effectively attenuate deterioration of albuminuria in patients with type 2 diabetes. This effect is likely mediated by an improvement of adhesion molecules.

Evaluation of the Relationship Between Microalbuminuria and Urine Ischemia-Modified Albumin Levels in Patients with Diabetic Nephropathy.

IntroductionIschemia‐modified albumin (IMA) is a marker which can be associated with oxidative stress in various ischemic and non‐ischemic processes. Oxidative stress plays roles in diabetes mellitus, its complications and pathogenesis. Serum IMA levels are examined in various clinical events. However, urine IMA levels have not yet been evaluated in diabetic patients. In this study, we aim to examine the relationship between metabolic features and urine microalbuminuria levels of diabetic patients and their urine IMA levels.Materials and MethodsThere were totally 50 type 2 diabetic patients in the study at the Mevlana University Hospital. Patients with cerebrovascular disease, acute myocardial infarction, hemodialysis patients with end stage chronic renal failure, pulmonary embolism, and malignant disease were excluded from the study. Metabolic features, urine IMA levels and cardiological parameters of patients were evaluated.ResultsMean age of patients was 59 ± 9 years, 20 of them (40%) were male and 30 of them (60%) were female. There were six patients with albuminuria value of <0.03 mg/g (normal), there were 39 patients with microalbuminuria value of 0.03–0.3 mg/g and there were five patients with macroalbuminuria of >0.3 mg/g. According to the analysis of patients with microalbuminuria (n = 39), there was no correlation between IMA levels and numerical demographic data, albuminuria, glucose, HbA1c, lipid profile, creatinine, uric acid, hematological parameters.DiscussionConclusively, there was no relationship between urine IMA levels and microalbuminuria related to the diabetic nephropathy. These findings can be associated with urinary excretion mechanisms of IMA.

Novel hydrogen sulfide-releasing compound, S-propargyl-cysteine, prevents STZ-induced diabetic nephropathy

In this work, we demonstrated for the first time that S-propargyl-cysteine (SPRC, also named as ZYZ-802), a novel hydrogen sulfide (H2S)-releasing compound, had renoprotective effects on streptozotocin (STZ)-induced diabetic kidney injury. SPRC treatment significantly reduced the level of creatinine, kidney to body weight ratio and in particular, markedly decreased 24-h urine microalbuminuria excretion. SPRC suppressed the mRNA expression of fibronectin and type IV collagen. In vitro, SPRC inhibited mesangial cells over-proliferation and hypertrophy induced by high glucose. Additionally, SPRC attenuated inflammation in diabetic kidneys. SPRC also reduced transforming growth factor β1 (TGF-β1) signaling and expression of phosphorylated Smad3 (p-Smad3) pathway. Moreover, SPRC inhibited phosphorylation of ERK, p38 protein. Taken together, SPRC was demonstrated to be a potential therapeutic candidate to suppress diabetic nephropathy.

Early Clinical Implications of Microalbuminuria in Patients with Acute Ischaemic Stroke

Cardiovascular and cerebrovascular diseases are leading causes of morbidity and mortality worldwide. Stroke accounts for the second leading cause of death, about 11.13% of total deaths worldwide. Microalbuminuria is known to be associated with increased risk of mortality in ischaemic stroke patients. But there have been no studies to assess whether microalbuminuria affects the early clinical outcome of patients with acute ischaemic stroke. This study aims to investigate whether microalbuminuria affects the early clinical outcome of patients with acute ischaemic stroke. This is a prospective study of patients with ischaemic stroke (who presented within 24 hours of symptom onset) who were consecutively admitted in three tertiary care centres during the time period from November 2013 to June 2015. Early clinical outcomes in patients were assessed by investigating the presence of Early Neurological Deterioration (END) using the National Institute of Health Stroke Scale. Urine albumin creatinine ratio was divided into two categories - Normal (less than 30mg/g of creatinine) or Urine Microalbuminuria (30-300 mg/g of creatinine). Total 42 out of 70 patients (60%) were found to have microalbuminuria. In multivariate logistic regression analysis, microalbuminuria was found to be independently associated with END in patients with acute ischaemic stroke (p=0.044). In the early periods following acute ischaemic stroke, patients with microalbuminuria have worse clinical outcome.

Retinal Vascular Tortuosity in Hospitalized Patients with Type 2 Diabetes and Diabetic Retinopathy in China

Context: Diabetic patients are at high risk for microvascular complications of disease such as diabetic retinopathy (DR) and diabetic neuropathy. Imaging the retinal micro-vasculature offers a chance to measure quantitatively the microvascular changes in diabetic patients’ onset and progression. However, the relation between retinal biomarkers and diabetic risk factors is unclear in Chinese hospitalized type 2 diabetic patients. Aims: To examine the associations of retinal vascular tortuosity with risk factors of type 2 diabetes and diabetic retinopathy in Chinese hospitalized patients. Patients and Methods: Our cross-sectional study includes 504 participants with type 2 diabetes hospitalized in the department of endocrinology in Shengjing hospital, Shenyang, China. Patients’ socio-demographic, clinical and biological information was retrieved from their ID card, the interview, and the local hospital information system. Retinal photographs were taken by laser-scanning ophthalmoscopy of both eyes and checked if gradable for analysis. The weighted mean and standard deviation of tortuosity were calculated from the retinal photographs using a novel robust and fully automatic quantitative method. DR was assessed from the retinal photographs by the ophthalmologist according to the modified Airlie House classification into No DR and Any DR in our current study. Data were analyzed by SPSS Version 22 with Student’s t test, Mann-Whitney U test, Chi-square test, and linear regression. Results: For the total participants (504) in this study, the weighted mean and standard deviation (SD) of tortuosity was 12.05 × 10?3 (SD: 1.66 × 10?3) and 24.31 × 10?3 (SD: 3.69 × 10?3), respectively. 386 (76.6%) patients were diagnosed with DR who had older age, long duration of diabetes, higher brachial ankle pulse wave velocity (baPWV), higher systolic blood pressure (SBP), higher diastolic blood pressure (DBP), and higher retinal vascular tortuosity values. In univariable linear regression analyses, older age, longer duration, higher baPWV, higher urine microalbuminuria, higher urine albumin/creatinine ratio, diagnosed with high blood pressure, thrombosis or Any DR, were significantly associated with both higher tortuosity measures (all P values