Shahid Syed Muhammad, Nawab Syeda Nuzhat, Shaikh Rozeena, Mahboob Tabassum
The Karachi Institute of Biotechnology & Genetic Engineering, University of Karachi, Karachi, Pakistan.
Pak J Pharm Sci. 2012 Jan;25(1):123-9.
Diabetes mellitus is a chronic metabolic disorder that can lead to serious cardiovascular, renal, neurologic and retinal complications. Diabetes clustered with hypertension and nephropathy has become the leading cause of end-stage renal disease globally. This study describes diabetes, hypertension and nephropathy with reference to glycemic control, dyslipidemia and endothelial dysfunction indicating the foremost basis of morbidity and mortality world wide and rapidly progressing in Pakistan. Study subjects selected and divided in four groups (60 each) followed by institutional ethical approval and informed consent. Group 1: non-diabetic, normotensive control subjects; Group 2: diabetic, normotensive patients; Group 3: diabetic, hypertensive patients and Group 4: diabetic, hypertensive patients with nephropathy. Their fasting blood samples analyzed for the estimations of blood glucose, HbA1c, serum triglyceride, cholesterol, LDL-cholesterol, HDL-cholesterol, urea, creatinine, nitric oxide and sialic acid levels. Results showed that all the groups showed significant rise in fasting blood glucose. Similarly HbA1c levels were also significantly high in all the patients as compared to controls. Group 2 showed significantly high serum cholesterol and LDL levels and low HDL levels. Group 3 and 4 showed significantly high serum triglyceride, cholesterol and LDL levels where as low HDL levels as compared to controls. Group 3 showed significantly high serum creatinine. Group 4 showed a significantly high serum urea and creatinine as compared to controls. Persistent albuminuria was characteristic in Group 4 patients. Significantly low production of serum nitric oxide with high concentration of serum sialic acid was observed in Group 3 and 4 as compared to controls. Results indicate a clear relationship of declining renal function with poor glycemic control, abnormal lipid metabolism, endothelial dysfunction and initiation of acute phase response in tissues affected from the microvascular complications of diabetes like hypertension and nephropathy. It must be taken into account while screening diabetic patients to get them rid of progressive renal impairment leading to end stage renal disease.
糖尿病是一种慢性代谢紊乱疾病，可导致严重的心血管、肾脏、神经和视网膜并发症。糖尿病合并高血压和肾病已成为全球终末期肾病的主要原因。本研究根据血糖控制、血脂异常和内皮功能障碍描述了糖尿病、高血压和肾病，这些因素是全球发病和死亡的首要基础，且在巴基斯坦迅速发展。研究对象经机构伦理批准并获得知情同意后，被分为四组（每组60人）。第1组：非糖尿病、血压正常的对照受试者；第2组：糖尿病、血压正常的患者；第3组：糖尿病、高血压患者；第4组：糖尿病、高血压合并肾病患者。对他们的空腹血样进行分析，以测定血糖、糖化血红蛋白、血清甘油三酯、胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、尿素、肌酐、一氧化氮和唾液酸水平。结果显示，所有组的空腹血糖均显著升高。同样，与对照组相比，所有患者的糖化血红蛋白水平也显著升高。第2组的血清胆固醇和低密度脂蛋白水平显著升高，高密度脂蛋白水平降低。与对照组相比，第3组和第4组的血清甘油三酯、胆固醇和低密度脂蛋白水平显著升高，而高密度脂蛋白水平降低。第3组的血清肌酐显著升高。与对照组相比，第4组的血清尿素和肌酐显著升高。持续性蛋白尿是第4组患者的特征。与对照组相比，第3组和第4组血清一氧化氮生成显著降低，血清唾液酸浓度升高。结果表明，肾功能下降与血糖控制不佳、脂质代谢异常、内皮功能障碍以及糖尿病微血管并发症（如高血压和肾病）影响的组织中急性期反应的启动之间存在明显关联。在筛查糖尿病患者时必须考虑到这一点，以使他们摆脱导致终末期肾病的进行性肾功能损害。
