Effects of angiotensin Ⅱ type 1 receptor blockers on urinary nephrin and Beclin-1 mRNA excretion in urine of patients with early diabetic nephropathy

doi:10.3969/j.issn.1004-583X.2021.11.009

Abstract

Abstract:

Objective To observe the urinary excretion of podocytes, podocyte-related protein nephrin and autophay gene Beclin-1 mRNA of patients with early diabetic nephropathy(DN) and the effects of Losartan on the above indicators.Methods Forty-eight cases of early DN patients in our hospital from January 2018 to January 2021 were selected and given Losartan 50 mg or 100 mg orally for 6 months. The urine of early DN patients was sampled to determine the excretion of microalbumin, podocytes, podocyte-related protein nephrin mRNA, and autophagy gene Beclin-1 mRNA before and after treatment.Results The urinary excretion of microalbumin, podocyte, podocyte-related protein nephrin, autophagy gene Beclin-1 mRNA of early DN patients were significantly increased compared with healthy people (P<0.01). After six months of treatment with Losartan, urinary excretion of microalbumin and podocytes in patients with early DN decreased (P<0.05).The urinary excretion of nephrin mRNA showed a downward trend (P<0.05). The autophagy gene Beclin-1 mRNA excretion increased to a certain extent after treatment, but the difference was not statistically significant (P=0.067).Conclusion Podocyte damage can be confirmed by urine examination in patients with early DN.Angiotensin Ⅱ type 1 receptor blockers can reduce the excretion of microalbumin to protect podocytes and enhance podocyte autophagy in early ND patients.

Key words: diabetic nephropathy, angiotensin Ⅱ type 1 receptor blockers, podocyte

CLC Number:

R587.24

Liu Lunzhi, Deng Lu, Zhang Mingxia. Effects of angiotensin Ⅱ type 1 receptor blockers on urinary nephrin and Beclin-1 mRNA excretion in urine of patients with early diabetic nephropathy[J]. Clinical Focus, 2021, 36(11): 1005-1008.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.11.009

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I11/1005

Figures/Tables 5

References 19

[1]	Li Y, Teng D, Shi X, et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: National cross sectional study[J]. BMJ, 2020, 369:m997.
[2]	Zhang L, Long J, Jiang W, et al. Trends in chronic kidney disease in China[J]. N Engl J Med, 2016, 375(9):905-906. doi: 10.1056/NEJMc1602469 URL
[3]	Sagoo MK, Gnudi L. Diabetic nephropathy: An overview[J]. Methods Mol Biol, 2020, 2067:3-7.
[4]	Anders HJ, Huber TB, Isermann B, et al. CKD in diabetes: Diabetic kidney disease versus nondiabetic kidney disease[J]. Nat Rev Nephrol, 2018, 14(6):361-377. doi: 10.1038/s41581-018-0001-y URL
[5]	陈香美. 中国肾脏病学发展的现状与未来[J]. 中国医学信息导报, 2021, 36(5):19.
[6]	Podgórski P, Konieczny A, Lis L, et al. Glomerular podocytes in diabetic renal diseas[J]. Adv Clin Exp Med, 2019, 28(12):1711-1715. doi: 10.17219/acem/104534 pmid: 31851794
[7]	Fukuda A, Minakawa A, Kikuchi M, et al. Urinary podocyte mRNAs precede microalbuminuria as a progression risk marker in human type 2 diabetic nephropathy[J]. Sci Rep, 2020, 10(1):18209. doi: 10.1038/s41598-019-56597-3 URL
[8]	中华医学会糖尿病分会. 中国2型糖尿病防治指南(2017年版)[J]. 中国实用内科杂志, 2018, 38(4):292-344.
[9]	Kidney disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for diabetes management in chronic kidney disease[J]. Kidney Int, 2020, 98(4S):S1-S115. doi: 10.1016/j.kint.2020.06.019 URL
[10]	Tung CW, Hsu YC, Shih YH, et al. Glomerular mesangial cell and podocyte injuries in diabetic nephropathy[J]. Nephrology (Carlton), 2018, 23(Suppl 4):32-37. doi: 10.1111/nep.2018.23.issue-S4 URL
[11]	Li JH, Tao JL, Li H. Research advances in podocyte injury and its role in diabetic nephropathy[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2010, 32(5):590-596.
[12]	Kondapi K, Silambanan S, Moorthy S, et al. A study of the risk factors and urinary podocin as an early prognostic indicator of renal injury in diabetic nephropathy[J]. J Assoc Physicians India, 2021, 69(6):11-12.
[13]	Kondapi K, Kumar NL, Moorthy S, et al. A study of association of urinary nephrin with albuminuria in patients with diabetic nephropathy[J]. Indian J Nephrol, 2021, 31(2):142-148. doi: 10.4103/ijn.IJN_305_19 URL
[14]	Hudkins KL, Wietecha TA, Steegh F, et al. Beneficial effect on podocyte number in experimental diabetic nephropathy resulting from combined atrasentan and RAAS inhibition therapy[J]. Am J Physiol Renal Physiol, 2020, 318(5):F1295-F1305. doi: 10.1152/ajprenal.00498.2019 URL
[15]	张彤, 凌宏威, 应长江, 等. 沙格列汀联合缬沙坦对早期2型糖尿病肾病患者炎性指标与肾功能的影响[J]. 疑难病杂志, 2020, 19(4):353-357.
[16]	Liu WJ, Huang WF, Ye L, et al. The activity and role of autophagy in the pathogenesis of diabetic nephropathy[J]. Eur Rev Med Pharmacol Sci, 2018, 22(10):3182-3189.
[17]	Seong SB, Ha DS, Min SY, et al. Autophagy Precedes apoptosis in angiotensin II-induced podocyte injury[J]. Cell Physiol Biochem, 2019, 53(5):747-759. doi: 10.33594/000000000 URL
[18]	Wang Q, Li R, Xiao Z, et al. Lycopene attenuates high glucose-mediated apoptosis in MPC5 podocytes by promoting autophagy via the PI3K/AKT signaling pathway[J]. Exp Ther Med, 2020, 20(3):2870-2878.
[19]	Yang D, Livingston MJ, Liu Z, et al. Autophagy in diabetic kidney disease: Regulation pathological role and therapeutic potential[J]. Cell Mol Life Sci, 2018, 75(4):669-688. doi: 10.1007/s00018-017-2639-1 URL

组别	例数	空腹血糖 (mmol/L)	胆固醇 (mmol/L)	血浆白蛋白 (g/L)	血肌酐 (μmol/L)
对照组	30	4.95±0.85	3.95±0.92	42.26±9.72	78.63±14.46
DN组	48	6.33±1.20^*	4.87±1.12^*	40.01±6.12	79.44±15.40
t值		0.513	3.786	1.254	0.234
P值		0.000	0.000	0.214	0.815

组别	例数	空腹血糖 (mmol/L)	胆固醇 (mmol/L)	血浆白蛋白 (g/L)	血肌酐 (μmol/L)
对照组	30	4.95±0.85	3.95±0.92	42.26±9.72	78.63±14.46
DN组	48	6.33±1.20^*	4.87±1.12^*	40.01±6.12	79.44±15.40
t值		0.513	3.786	1.254	0.234
P值		0.000	0.000	0.214	0.815

检测时间	例数	空腹血糖 (mmol/L)	胆固醇 (mmol/L)	血浆白蛋白 (g/L)	血肌酐 (μmol/L)
治疗前	48	6.33±1.20	4.87±1.12	40.01±6.12	79.44±15.40
治疗后	48	6.13±1.23	4.68±1.18	39.98±3.46	77.04±14.18
t值		0.824	0.766	0.035	0.737
P值		0.414	0.448	0.972	0.465

检测时间	例数	空腹血糖 (mmol/L)	胆固醇 (mmol/L)	血浆白蛋白 (g/L)	血肌酐 (μmol/L)
治疗前	48	6.33±1.20	4.87±1.12	40.01±6.12	79.44±15.40
治疗后	48	6.13±1.23	4.68±1.18	39.98±3.46	77.04±14.18
t值		0.824	0.766	0.035	0.737
P值		0.414	0.448	0.972	0.465

组别	例数	足细胞排泄 (个/20个视野)	UACR (mg/g)
对照组	30	0.10±0.31	23.13±11.24
DN组	48	23.63±5.23	249.88±36.58
t值		5.160	32.957
P值		0.000	0.000