Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Department of Physiology, St. Marianna University School of Medicine, Kanagawa, Japan.
Clin Exp Nephrol. 2021 Apr;25(4):365-375. doi: 10.1007/s10157-020-02007-2. Epub 2021 Jan 6.
The aim of this study is to investigate the renoprotective effect of the GLP-1 receptor agonist, liraglutide, in early-phase diabetic kidney disease (DKD) using an animal model of type 2 diabetes with several metabolic disorders.
Male 8-week-old spontaneously diabetic Torii (SDT) fatty rats (n = 19) were randomly assigned to three groups. The liraglutide group (n = 6) was injected subcutaneously with liraglutide. Another treatment group (n = 6) received subcutaneous insulin against hyperglycemia and hydralazine against hypertension for matching blood glucose levels and blood pressure with the liraglutide group. The control groups of SDT fatty (n = 7) and non-diabetic Sprague-Dawley rats (n = 7) were injected only with a vehicle.
The control group of SDT fatty rats exhibited hyperglycemia, obesity, hypertension, hyperlipidemia, glomerular sclerosis, and tubulointerstitial injury with high urinary albumin and L-FABP levels. Liraglutide treatment reduced body weight, food intake, blood glucose and blood pressure levels, as well as ameliorated renal pathologic findings with lower urinary albumin and L-FABP levels. Liraglutide increased expressions of phosphorylated (p)-eNOS and p-AMPK in glomeruli, downregulated renal expression of p-mTOR, and increased renal expressions of LC3B-II, suggesting activation of autophagy. However, these effects were not caused by the treatments with insulin and hydralazine, despite comparable levels of hyperglycemia and hypertension to those achieved with liraglutide treatment.
Liraglutide may exert a renoprotective effect via prevention of glomerular endothelial abnormality and preservation of autophagy in early-phase DKD, independent of blood glucose, and blood pressure levels.
本研究旨在使用伴有多种代谢紊乱的 2 型糖尿病动物模型,探讨 GLP-1 受体激动剂利拉鲁肽对早期糖尿病肾病(DKD)的肾脏保护作用。
雄性 8 周龄自发性糖尿病 Torii(SDT)肥胖大鼠(n=19)随机分为 3 组。利拉鲁肽组(n=6)皮下注射利拉鲁肽。另一个治疗组(n=6)接受皮下胰岛素治疗以控制高血糖和肼屈嗪治疗以控制高血压,以与利拉鲁肽组匹配血糖和血压。SDT 肥胖对照组(n=7)和非糖尿病 Sprague-Dawley 对照组(n=7)仅注射载体。
SDT 肥胖对照组大鼠出现高血糖、肥胖、高血压、高血脂、肾小球硬化和小管间质损伤,同时伴有高尿白蛋白和 L-FABP 水平。利拉鲁肽治疗降低了体重、摄食量、血糖和血压水平,改善了肾脏病理变化,降低了尿白蛋白和 L-FABP 水平。利拉鲁肽增加了肾小球中磷酸化(p)-eNOS 和 p-AMPK 的表达,下调了肾脏中 p-mTOR 的表达,增加了肾脏中 LC3B-II 的表达,表明自噬被激活。然而,这些作用不是由胰岛素和肼屈嗪治疗引起的,尽管它们可以达到与利拉鲁肽治疗相似的高血糖和高血压水平。
利拉鲁肽可能通过预防肾小球内皮异常和维持自噬来发挥早期 DKD 的肾脏保护作用,而与血糖和血压水平无关。