Department of Chemistry, College of Science, University of Basrah, Basrah, Iraq.
Department of Basic Medical Sciences, College of Nursing, University of Basrah, Basrah, Iraq.
J Med Invest. 2021;68(1.2):76-84. doi: 10.2152/jmi.68.76.
Diabetic Nephropathy (DN) is the leading reason of all excess death-rate over type-2 diabetes mellitus (T2DM) patients with microalbuminuria, macroalbuminuria or end-stage renal disease. This work was aimed to estimate insulin resistance (IR) effect on some markers and trace elements (Selenium, Zinc, Magnesium) levels for early predicting of DN in T2DM patients. METHODS : We conducted a cross-sectional clinical study. Blood and urine samples were collected from 63 subjects with T2DM and 33 healthy controls to assess glucose, insulin, IR, urea, creatinine, glomerular filtration rate (GFR), creatinine clearance (CrCl), homocysteine (Hcy), fructosamine (FA), cystatin C (CysC), albumin (Alb), neutrophil gelatinase-associated lipocalin (NGAL), 8-hydroxy-2`-deoxyguanosine (8-OHdG) and trace elements levels. Data were collected using a questionnaire that was filled out by specialized doctors. RESULTS : Compared with controls, the results revealed that T2DM patients with or without DN had significant increases in glucose, insulin, IR, urea, creatinine, Hcy, FA, CysC, Alb, NGAL and 8-OHdG and significant decreases in GFR, CrCl and trace elements levels. Body mass index (BMI) had no changes. CONCLUSION : Uncontrolled T2DM was associated with BMI, IR and physical activity in which elevated Hcy, FA, CysC, Alb, NGAL and 8-OHdG levels and decreased trace elements levels may be used as early clinical markers of DN. J. Med. Invest. 68 : 76-84, February, 2021.
糖尿病肾病（DN）是导致伴有微量白蛋白尿、大量白蛋白尿或终末期肾病的 2 型糖尿病（T2DM）患者超额死亡率的主要原因。本研究旨在评估胰岛素抵抗（IR）对某些标志物和痕量元素（硒、锌、镁）水平的影响，以便早期预测 T2DM 患者的 DN。方法：我们进行了一项横断面临床研究。收集了 63 例 T2DM 患者和 33 例健康对照者的血液和尿液样本，以评估血糖、胰岛素、IR、尿素、肌酐、肾小球滤过率（GFR）、肌酐清除率（CrCl）、同型半胱氨酸（Hcy）、果糖胺（FA）、胱抑素 C（CysC）、白蛋白（Alb）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、8-羟基-2`-脱氧鸟苷（8-OHdG）和痕量元素水平。数据由专门的医生填写问卷收集。结果：与对照组相比，结果显示 T2DM 患者无论是否患有 DN，其血糖、胰岛素、IR、尿素、肌酐、Hcy、FA、CysC、Alb、NGAL 和 8-OHdG 均显著升高，GFR、CrCl 和痕量元素水平显著降低。体重指数（BMI）没有变化。结论：未控制的 T2DM 与 BMI、IR 和体力活动有关，其中升高的 Hcy、FA、CysC、Alb、NGAL 和 8-OHdG 水平以及降低的痕量元素水平可能作为 DN 的早期临床标志物。医学研究杂志 68:76-84, 2021 年 2 月。
