Li Z Y, Liu B, Zhuang X J, Shen Y D, Tian H R, Ji Y, Li L X, Liu F
Department of Endocrinology and Metabolism, Jinshan Branch, Shanghai Sixth People's Hospital, Shanghai 201599, China.
Zhonghua Yi Xue Za Zhi. 2018 Dec 11;98(46):3756-3761. doi: 10.3760/cma.j.issn.0376-2491.2018.46.007.
To investigate the effects of berberine on urine albumin/creatine ratio (UACR) and serum cystatin C (Cys C) in patients with type 2 diabetes mellitus (T2DM). A total of 114 T2DM inpatients or outpatients, including 46 males and 68 females aged (55±14) years between January 2015 and January 2016 were randomly divided into two groups: the control group (=57) only with hypoglycemic agents, and the intervention group (=57) with berberine (0.4 g, 3 times a day) on the basis of treatment from the control group. Both groups were treated and followed up for six months. All the clinical and biochemical parameters were routinely evaluated before and after treatment. And the safety of berberine was assessed. After the treatment, the improvement of glycosylated hemoglobin (HbA1c), blood urea nitrogen (BUN), systolic pressure (SP), high sensitive C-reactive protein (hs-CRP), rythrocyte sedimentation rate (ESR), estimated glomerular filtration rate (eGFR) in the intervention group were significantly better than those in the control group (all <0.05), as well as the UACR[47(26, 120) mg/g vs 103(42, 267) mg/g, <0.001]and serum Cys C[(0.83±0.30) mg/L vs (0.98±0.25) mg/L, =0.031]. However, there was no statistically significant difference of UACR and Cys C between before and after treatment in the control group (all >0.05). Compared to the control group, the patients in the intervention group had lesser UACR[47(26, 120) mg/g vs 68(28, 158) mg/g, =0.039], and lower serum Cys C[(0.83±0.30) mg/L vs (0.96±0.30)mg/L, =0.041]. Berberine had no obvious adverse effects. Multiple linear regression analysis revealed that the berberine administration was independently associated with the reduction of UACR (β=-0.051, =0.041) and Cys C (β=-0.068, =0.033) in T2DM patients. Berberine improves diabetic kidney disease by reducing UACR and serum Cys C in T2DM patients, and it was safe.
探讨黄连素对2型糖尿病(T2DM)患者尿白蛋白/肌酐比值(UACR)及血清胱抑素C(Cys C)的影响。选取2015年1月至2016年1月期间收治的114例T2DM住院或门诊患者,其中男性46例,女性68例,年龄(55±14)岁,随机分为两组:对照组(n = 57)仅给予降糖药物治疗,干预组(n = 57)在对照组治疗基础上加用黄连素(0.4 g,每日3次)。两组均治疗并随访6个月。治疗前后常规评估所有临床和生化指标,并评估黄连素的安全性。治疗后,干预组糖化血红蛋白(HbA1c)、血尿素氮(BUN)、收缩压(SP)、高敏C反应蛋白(hs-CRP)、红细胞沉降率(ESR)、估算肾小球滤过率(eGFR)的改善情况均显著优于对照组(均P < 0.05),UACR[47(26,120)mg/g比103(42,267)mg/g,P < 0.001]和血清Cys C[(0.83±0.30)mg/L比(0.98±0.25)mg/L,P = 0.031]亦是如此。然而,对照组治疗前后UACR和Cys C差异无统计学意义(均P > 0.05)。与对照组相比,干预组患者UACR较低[47(26,120)mg/g比68(28,158)mg/g,P = 0.039],血清Cys C较低[(0.83±0.30)mg/L比(0.96±0.30)mg/L,P = 0.041]。黄连素无明显不良反应。多元线性回归分析显示,给予黄连素与T2DM患者UACR降低(β = -0.051,P = 0.041)和Cys C降低(β = -0.068,P = 0.033)独立相关。黄连素通过降低T2DM患者的UACR和血清Cys C改善糖尿病肾病,且安全性良好。