Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011881 (diabetic nephropathy)
 10,836 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study was undertaken to evaluate the effects of a selective thromboxane synthetase inhibitor (OKY-046) on urinary prostaglandins (PGs) excretion and renal parameters such as endogenous creatinine clearance rate (Ccr) and urinary protein excretion in streptozotocin (STZ)-induced diabetic rats. STZ-diabetic rats were divided into two groups; one fed standard chow (DM1) and the other, standard chow mixed with 0.1% OKY-046 (DM2) for 24 weeks. Male Wistar rats were fed standard chow for 24 weeks as control (C). Urinary thromboxane B2 (TXB2) and 6-keto-PGF1 alpha excretions significantly increased in STZ-induced diabetic rats (DM1 and DM2) compared with C after 24 weeks. The increased urinary TXB2 excretion in DM2 was significantly reduced (p < 0.05) compared with that in DM1 (261.1 +/- 18.6 ng/gCr versus 380.0 +/- 48.4 ng/gCr, mean +/- SEM). No significant difference could be found in urinary protein excretion between DM1 and DM2, which was significantly higher in both diabetic groups than C after 12 and 24 weeks. Ccr in both DM1 and DM2 significantly increased (p < 0.05) compared with C after 12 weeks. In contrast, after 24 weeks, Ccr in DM1 fell down to 0.18 +/- 0.02 mL/min 100 g body weight (BW), thus being significantly lower (p < 0.05) than that in C (0.27 +/- 0.03 mL/min 100 g BW) and DM2 (0.25 +/- 0.02 mL/min 100 g BW). Electron microscopic findings in diabetic rats after 24 weeks were the typical change of early diabetic nephropathy, whereas there were no obvious differences between DM1 and DM2.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of thromboxane synthetase inhibitor (OKY-046) on urinary prostaglandin excretion and renal function in streptozotocin-induced diabetic rat. 806 49

This study aimed to investigate the clinical characteristics of sudden death (SD) in type 2 diabetes mellitus (DM2). Clinical data from 1988 through 1996 in our hospital showed that 130 hospitalized patients with DM2 died, and 17 of them died of SD (13.08%). These 17 SD patients were pair-matched with 17 DM2 patients who were alive in the same period. The results revealed that the SD group had longer clinical DM duration, more chronic diabetic complications and higher blood pressure. In the direct causes of SD, cardiac SD accounted for 76.47%. The others were non-cardiac factors, including cerebral hemorrhage, hyperkalemia from diabetic nephropathy with renal failure and respiratory tract obstruction from lung infection. The triggering causes included eating, defecting, lung infection, strenuous attempt, hypoglycemia and surgical operation. To reduce the rate of SD in DM2, it is necessary and vital to treat the DM2 itself, and to take positive steps to prevent the onset of SD in high risk patients.
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PMID:[A clinical study of sudden death in patients with type 2 diabetes mellitus]. 1221 1

The objective of the work was to assess, based on the results of studies conducted abroad and the author's own results from the Prague register of diabetic patients, whether there exist differences in the epidemiology, clinical course of diabetes mellitus (DM) and its complications between female and male diabetics. As far as type 1 DM is concerned there are significant differences in the clinical course of diabetes, i.e. deteriorated compensation of DM in girls and women in conjunction with menstruation and the menopause. As compared with men, young women have a higher mortality on account of diabetic nephropathy, and at any age they have as higher incidence of hypertension. In DM2 they have also a high incidence of hypertension and risk of compensation of DM during menstruation and later during the menopause. A significantly less frequent complication in women is ischaemia of the lower extremities. From the epidemiological aspect a higher prevalence of DM2 was proved in women after the age of 65 years.
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PMID:[Women and diabetes]. 1264 20

Microalbuminuria is a marker for diabetic nephropathy. It also signifies cardiovascular disease, as well as nephropathy, in type 2 diabetes (DM2). Microalbuminuria may precede DM2, occurring with the insulin resistance syndrome and its components, including obesity and hypertension. Other indicators of cardiovascular risk, such as markers of inflammation, are associated with microalbuminuria in populations of patients with and without diabetes. With the rising prevalence of DM2 in minority youth, especially in Native Americans, a marker for future disease risk would allow earlier prevention strategies to be tested. Before microalbuminuria can be used in a prevention strategy, more needs to be known about the mechanism(s) of the association between elevated excretion, its relationship to glucose intolerance, and its relative contribution to cardiovascular and renal disease. These questions are especially applicable as we begin to observe the long-term complications of diabetes in youth.
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PMID:Microalbuminuria as a marker of cardiovascular and renal risk in type 2 diabetes mellitus: a temporal perspective. 1476 31

Hyperfiltration has been implicated in the progression toward diabetic nephropathy in type 2 diabetes mellitus (DM2). This study focuses for the first time on the in vivo modulation of single-nephron GFR (SNGFR) in the classic B6.Cg-m(+/+)Lepr(db)/J (db/db) mouse model of DM2. To obtain stable preparations, it was necessary to use a sustaining infusion of 3.3 ml.100 g body wt(-1) x h(-1), or higher. SNGFR (measured both proximally and distally) was greater in db/db vs. heterozygote (db/m) mice (P < 0.05) but not vs. the wild-type (WT) mice. The tubuloglomerular feedback (TGF) responses, determined as free-flow proximal vs. distal SNGFR differences, were significant in db/db mice (11.6 +/- 0.8 vs. 9.3 +/- 1.0 nl/min, P < 0.01), in db/m mice (8.0 +/- 0.8 vs. 7.2 +/- 0.6 nl/min, P < 0.02), and WT mice (9.9 +/- 0.6 vs. 8.9 +/- 0.7 nl/min, P < 0.05). After increasing the sustaining infusion in the db/db mice, to offset glycosuric urine losses, the SNGFR increased significantly, and the TGF response was abolished. In these volume-replete db/db mice, absolute fluid reabsorption measured both at the late proximal and distal tubular sites were significantly increased vs. db/m mice infused at 3.3 ml.100 g body wt(-1) x h(-1). After infusion of the neuronal nitric oxide synthase (nNOS) inhibitor S-methylthiocitrulline, SNGFR fell in both db/db and db/m mice. These studies show that SNGFR is elevated in this mouse model of DM2, is suppressed by nNOS inhibition, and is modulated by TGF influences that are altered by the diabetic state and responsive to changes in extracellular fluid volume.
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PMID:Modulation of single-nephron GFR in the db/db mouse model of type 2 diabetes mellitus. 1653 22

With the aim to determine the influence of reducing systolic blood pressure in urinary TGF-beta1 of type 2 diabetes (DM2) with diabetic nephropathy (DN), 21 subjects with type 2 diabetes and proteinuria >500 mg/24 h were studied. Amlodipine and ramipril were added to their previous antihypertensive treatment for 12 weeks. Urinary TGF-beta1 (UTGF-beta1) was determined at 0, 4, 8 and 12 weeks. Plasma TGF-beta1 was determined at 0 and 12 weeks. Subjects whose mean systolic blood pressure (SBP) during treatment were under 140 mmHg were grouped as the better SBP controlled group (n = 11) and those with SBP equal to or greater than 140 mHg were grouped in a moderate SBP controlled group (n = 10). Compared to baseline, mean log UTGF-beta1 at 4, 8 and 12 weeks decreased (-0.22 +/- 0.15 pg/mg; p = 0.04) in better SBP controlled group but not in the moderate SBP controlled group (-0.12 +/- 0.08 pg/mg, p = 0.82). Mean SBP correlated with UTGF-beta1 (r = 0.458, p = 0.0357), and this effect was independent of HbA1c (p = 0.042). By controlling SBP in DM2 subjects with DN we might decrease UTGF-beta1. We propose that reduction of UTGF-beta1 is due to a decrease in renal TGF-beta1 production.
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PMID:Urinary TGF-beta1 reduction related to a decrease of systolic blood pressure in patients with type 2 diabetes and clinical diabetic nephropathy. 1641 43

The aim was to compare in patients with type 2 diabetes mellitus (DM2) the prevalence of the metabolic syndrome according to the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) definitions, and to analyze the association between them and the complications of DM2. Patients with DM2 (n= 753) were evaluated for ethnics, anthropometrics and laboratory parameters and for the presence of DM2 complications: diabetic nephropathy, coronary artery disease, stroke, diabetic retinopathy and peripheral vascular disease. Insulin resistance was estimated using the HOMA index. Metabolic syndrome was found in 671 (89%) and 657 (87%) patients using the WHO definition and the NCEP definition, respectively. In the total group, there was a moderate agreement between the two definitions (k= 0.54; 95% CI 0.49-0.59), although, it was better for black patients (k= 0.69; 95% CI 0.60-0.78) than white (k= 0.54; 95% CI 0.48-0.6) or mulattos patients (k= 0.26; 95% CI 0.09-0.43). Patients with metabolic syndrome using the NCEP criteria had higher HOMA-IR values compared to those without metabolic syndrome (p= 0.001). This differentiation was not seen using the WHO definition (p= 0.152). The proportion of diabetic complications was similar for both definitions. In conclusion, regarding the risk of diabetic complications both definitions are equivalent. However, there are some ethnic differences in the agreement between the two definitions.
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PMID:[Analysis of the criteria used for the definition of metabolic syndrome in patients with type 2 diabetes mellitus]. 1676 92

Determination of microalbuminuria has been shown to be useful to identify patients with type 2 diabetes (DM2) at high risk of renal and cardiovascular (CV) diseases. The determination of the albumin/creatinine (Cr) ratio in an isolate sample of urine has been shown to be sufficient for the diagnosis as well as for the evaluation of the efficacy of the therapy employed to reduce microalbuminuria. Values of urinary albumin >30 mg/g of Cr or 3,4 mg/mmol of Cr are evidence of microalbuminuria. This condition is frequently associated with high blood pressure levels, which increases dramatically not only the progression of renal disease but also de risk of a CV event. Epidemiologic studies have demonstrated that the presence of microalbuminuria is predictive of higher morbi-mortality independent of the presence of other CV risk factors. It appears to reflect a generalized vascular lesion not confined to the glomeruli. The capacity of reducing blood pressure, intraglomerular pressure and the permeability of the glomerular membrane, which are important factors in the progression of renal disease, may explain the renoprotective effects of the angiotensin converting enzyme inhibitors (ACEIs) and the angiotensin II receptors blockers (ARBs). In the treatment of diabetic nephropathy, the control of blood pressure, which has to be maintained near or below 130/80 mmHg associated to the blockade of the renin-angiotensin system with ACEIs or BRAs are the best strategies to promote renal and CV protection.
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PMID:[Microalbuminuria: cardiovascular and renal risk factors underestimated in clinical practice]. 1676 97

Twenty to forty percent of type-2 diabetic patients (DM2) present nephropathy. Genetic polymorphism of Apolipoprotein E (Apo E) has been proposed as a risk factor in the development and progression of diabetic nephropathy. The purpose of the study was to evaluate the relationship between Apo E polymorphism and presence of nephropathy in DM2 patients. We studied 85 DM2 patients with a similar nutritional state, environmental and socioeconomic condition and more than 10 years of evolution. They were grouped in DM2 patients with kidney complications (n=56) and without kidney complications (n=29; control group). Apo E genotype was determined by restriction fragment-length polymorphism analysis. A plasmatic biochemical characterization was performed on all the subjects studied. The 85 DM2 patients had arterial hypertension in treatment. The nephropathy diabetic group showed differences (p<0.001) in BMI, systolic blood pressure, glycemia, cholesterol (total, HDL and LDL), HbA1c and creatinine. The e4 allelic frequency was 8% in the nephropathy group versus 25.9% in the control group. Apo e3 allele and E3/3 genotype frequency were higher and E3/4 genotype was lower in the nephropathy group than in controls. These groups also showed differences in total, HDL and LDL cholesterol. DM2 patients without nephropathy presented a higher frequency of e4 allele. These results could suggest a protective role of e4 allele in the development and progression of diabetic nephropathy.
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PMID:Relationship between Apolipoprotein E polymorphism and nephropathy in type-2 diabetic patients. 1748 71

Abdominal obesity is associated with cardiovascular disease. This study aims to compare two measures of abdominal obesity [waist and wais-to-hip ratio (WHR)] in patients with DM2 to identify cardiovascular risk factors: ischemic cardiopathy, hypertension, dislipidemia, obesity and diabetic nephropathy. A multicentric study was performed in 820 patients with type 2 DM. Waist circumference strongly correlated with body mass index (BMI), for men (r= 0.814; P< 0.05) and women (r= 0.770; P< 0.05). On the other hand, WRH was weakly correlated (r= 0.263, P< 0.05 for men; r= 0.092, P< 0.05 for women). Only waist circumference correlated with systolic pressure (r= 0.211, P< 0.05 for men; r= 0,224, P< 0.05 for women). ROC curve analysis demonstrated the superiority of waist circumference measurement compared to WHR regarding obesity and hypertension for men and women, and dyslipidemia for men. In conclusion, waist circumference is better correlated with cardiovascular risk factor than WRH.
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PMID:[Waist measure and waist-to-hip ratio and identification of clinical conditions of cardiovascular risk: multicentric study in type 2 diabetes mellitus patients]. 1754 44


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