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Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus.

ABSTRACT: Purpose:The purpose of this study was to identify diabetic nephropathy risk factors in type 2 diabetes mellitus obese people based on community type 2 diabetes mellitus patients. Patients and Methods:In the community in Shanghai, we conduct a questionnaire, physical examination, and biochemical examination. The 406 patients included in the analysis were divided into two groups based on whether or not they had diabetic nephropathy. The influencing factors of type 2 diabetes mellitus obese patients were screened by the least absolute shrinkage and selection operator method, and then the influencing factors detected by the least absolute shrinkage and selection operator method were included in the binary logistic regression analysis, and the risk factors for diabetic nephropathy in obese people with type 2 diabetes mellitus were obtained. Finally, the nomogram and forest plot are used to visualize the binary logistic regression results, and the calibration plot and receiver-operating characteristic curve are used to verify the result. Results:The results showed that family history of diabetes (OR= 2.091, P= 0.002), disease course (OR=1.050, P= 0.007). hypertension (OR=1.768, P=0.042), hyperuricemia (OR=2.263, P=0.003), systolic blood pressure (OR=1.027, P<0.001), and glycosylated haemoglobin A1c (OR=1.358, P<0.001) were risk factors for diabetic nephropathy. Conclusion:For obese patients with type 2 diabetes mellitus, they should pay attention to family history of diabetes, disease course and hyperuricemia. Hypertension should be concerned and strictly controlled. Systolic blood pressure and glycosylated haemoglobin A1c will help prolong the survival of diabetic nephropathy patients.

SUBMITTER: Hu F

PROVIDER: S-EPMC7352450 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus.

Hu Fan F Zhang Taotao T

International journal of general medicine 20200706

<h4>Purpose</h4>The purpose of this study was to identify diabetic nephropathy risk factors in type 2 diabetes mellitus obese people based on community type 2 diabetes mellitus patients.<h4>Patients and methods</h4>In the community in Shanghai, we conduct a questionnaire, physical examination, and biochemical examination. The 406 patients included in the analysis were divided into two groups based on whether or not they had diabetic nephropathy. The influencing factors of type 2 diabetes mellitu ...[more]

PMID: 32753935

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Project description:ObjectiveTo examine the association of bradykinin and related peptides with the development of diabetic nephropathy lesions in 243 participants with type 1 diabetes (T1D) from the Renin-Angiotensin System Study who, at baseline, were normoalbuminuric, normotensive and had normal or increased glomerular filtration rate (GFR).DesignPlasma concentrations of bradykinin and related peptides were measured at baseline by quantitative mass spectrometry. All participants were randomly assigned at baseline to receive placebo, enalapril or losartan during the 5 years between kidney biopsies. Kidney morphometric data were available from kidney biopsies at baseline and after 5 years. Relationships of peptides with changes in morphometric variables were assessed using multiple linear regression after adjustment for age, sex, diabetes duration, HbA1c, mean arterial pressure, treatment assignment and, for longitudinal analyses, baseline structure.ResultsBaseline median albumin excretion rate of study participants was 5.0 ?g/min, and mean GFR was 128 mL/min/1.73 m2. After multivariable adjustment, higher plasma concentration of bradykinin (1-8) was associated with greater glomerular volume (partial r = 0.191, P = 0.019) and total filtration surface area (partial r = 0.211, P = 0.010), and higher bradykinin (1-7) and hyp3-bradykinin (1-7) were associated with lower cortical interstitial fractional volume (partial r = -0.189, P = 0.011; partial r = -0.164, P = 0.027 respectively). In longitudinal analyses, higher bradykinin was associated with preservation of surface density of the peripheral glomerular basement membrane (partial r = 0.162, P = 0.013), and for participants randomized to losartan, higher hyp3-bradykinin (1-8) was associated with more limited increase in cortical interstitial fractional volume (partial r = -0.291, P = 0.033).ConclusionsHigher plasma bradykinin and related peptide concentrations measured before clinical onset of diabetic nephropathy in persons with T1D were associated with preservation of glomerular structures, suggesting that elevations of these kinin concentrations may reflect adaptive responses to early renal structural changes in diabetic nephropathy.

Project description:Diabetic foot is a serious condition in patients with a long lasting diabetes mellitus. Diabetic foot treated improperly may lead not only to delayed ulceration healing, generalized inflammation, unnecessary surgical intervention, but also to the lower limb amputation. The aim of this study was to compare diabetic foot risk factors in population with type 2 diabetes and risk factors for diabetes in healthy subjects.The study included 900 subjects: 145 with diabetic foot, 293 with type 2 diabetes without diabetic foot and 462 healthy controls matched in terms of mean age, gender structure and cardiovascular diseases absence. Study was conducted in Gastroenterology and Metabolic Diseases Department, Medical University of Warsaw, Poland. In statistical analysis a logistic regression model, U Mann-Whitney's and t-Student test were used.The binomial logit models analysis showed that the risk of diabetic foot in patients with type 2 diabetes was decreased by patient's age (odds ratio [OR] = 0.94; 95% confidence interval [CI]: 0.92-0.96; p = 0.00001) and hyperlipidaemia (OR = 0.54; 95% CI: 0.36-0.81; p = 0.01). In contrast, male gender (OR = 2.83; 95% CI: 1.86-4.28; p = 0.00001) diabetes duration (OR = 1.04; 95% CI: 1.03-1.06; p = 0.0003), weight (OR = 1.04; 95% CI: 1.03-1.06; p = 0.00001), height (OR = 1.08; 95% CI: 1.05-1.11; p = 0.00001) and waist circumference (OR = 1.028; 95% CI: 1.007-1.050; p = 0.006) increase the risk of diabetic foot. The onset of type 2 diabetes in healthy subjects was increased by weight (OR = 1.035; 95% CI: 1.024-1.046; p = 0.00001), WC (OR = 1.075; 95% CI: 1.055-1.096; p = 00001), hip circumference (OR = 1.03; 95% CI: 1.01-1.05; p = 0.005), overweight defined with body mass index (BMI) above 24,9 kg/m(2) (OR = 2.49; 95% CI: 1.77-3.51; p = 0.00001) and hyperlipidaemia (OR = 3.53; 95% CI: 2.57-4.84; p = 0.00001).Risk factors for Type 2 diabetes and diabetic foot are only partially common. Study proved that patients who are prone to developing diabetic foot experience different risk factors than patients who are at risk of diabetes. Identification of relationship between diabetic foot and diabetes risk factors in appropriate groups may help clinicians to focus on certain factors in diabetic foot prevention.

Dataset Information

Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus.

Publications

Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus.

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