Liu Jie, Guo Shanshan, Li Hui, Liu Xu-Ying
Jie Liu, Department of Endocrinology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China.
Shanshan Guo, Department of Nephrology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China.
Pak J Med Sci. 2022 May-Jun;38(5):1170-1174. doi: 10.12669/pjms.38.5.4719.
To investigate the effects of a glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide on podocytes, inflammation, and oxidative stress in patients with diabetic nephropathy (DN).
Eighty-four DN patients treated by the department of endocrinology of the Affiliated Hospital of Hebei University during December 2017 and March 2019 were randomly assigned to a control group and a treatment group (n=42, respectively), with the control group prescribed with conventional DN medications and the treatment group receiving liraglutide treatment in addition to the conventional therapy. The course of treatment lasted for 12 weeks. hemoglobin A1c (HbA1C), body mass index (BMI), total cholesterol (TC), triglyceride (TG), urinary albumin excretion rate (UAER), urine podocalyxin (PCX), urine nephrin, as well as inflammation and oxidative stress markers such as tumor necrosis factor α (TNF-α), monocyte chemotactic protein-1 (MCP-1), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were measured pre- and post-treatment for intergroup comparison.
After 12 weeks of treatment, HbA1C, BMI, TC, and TG in both groups were reduced in comparison with the pre-treatment levels, with the levels in the treatment group lower than in the control group (<0.05); reduced levels of UAER, PCX, and nephrin were detected in the two groups, with the treatment group exhibiting a significant reduction in these markers compared with the control group (<0.05); the 12-week treatment led to decreases in the TNF-α, MCP-1, and MDA levels in both groups, with the decline in the treatment group exceeding that in the control group, whereas both groups had an increased level of GSH-Px, with the level in the treatment group higher than that in the control group, and the differences were statistically significant (<0.05, respectively).
Liraglutide protects the kidneys and improves DN by inhibiting inflammation and oxidative stress, reducing urinary albumin excretion and podocyte damage and supporting renal function in addition to its hypoglycemic properties.
探讨胰高血糖素样肽-1受体激动剂（GLP-1RA）利拉鲁肽对糖尿病肾病（DN）患者足细胞、炎症及氧化应激的影响。
选取2017年12月至2019年3月在河北大学附属医院内分泌科接受治疗的84例DN患者，随机分为对照组和治疗组（每组n = 42），对照组给予常规DN药物治疗，治疗组在常规治疗基础上加用利拉鲁肽治疗。治疗疗程为12周。分别于治疗前后测定糖化血红蛋白（HbA1C）、体重指数（BMI）、总胆固醇（TC）、甘油三酯（TG）、尿白蛋白排泄率（UAER）、尿足细胞标记蛋白（PCX）、尿nephrin，以及炎症和氧化应激标志物如肿瘤坏死因子α（TNF-α）、单核细胞趋化蛋白-1（MCP-1）、谷胱甘肽过氧化物酶（GSH-Px）和丙二醛（MDA），进行组间比较。
治疗12周后，两组患者的HbA1C、BMI、TC和TG均较治疗前降低，且治疗组低于对照组（<0.05）；两组UAER、PCX和nephrin水平均降低，且治疗组这些指标较对照组显著降低（<0.05）；治疗12周后，两组TNF-α、MCP-1和MDA水平均降低，且治疗组下降幅度超过对照组，而两组GSH-Px水平均升高，且治疗组高于对照组，差异均有统计学意义（均<0.05）。
利拉鲁肽除具有降糖作用外，还可通过抑制炎症和氧化应激、减少尿白蛋白排泄及足细胞损伤、维持肾功能来保护肾脏并改善糖尿病肾病。
