Altern Ther Health Med. 2023 May;29(4):52-56.
Diabetic nephropathy (DN) is a common microvascular complication in diabetic patients. The pathogenesis of DN is complex. Inflammatory response may play a key role as a common downstream pathway.
The study intended to explore the relationship between the levels of plasma nucleotide-binding oligomeric domain-like receptor protein 3 (NLRP3 inflammasome), interleukin-1β (IL-1β), and IL-18 and the progression of type 2 diabetic nephropathy to clarify their relationship with type 2 diabetes mellitus (T2DM) and to provide evidence for clinical treatment.
The research team performed a controlled observational study.
The study took place at Baoding No. 1 Central Hospital in Baoding, Hebei, China.
Participants were 153 patients with T2DM who received treatment at the hospital between October 2020 and October 2021. The research team allocated 30 participants without evidence of DN to the control group. Based on the DN stage, the team assigned the 123 remaining participants to one of five observation groups: (1) 32 participants with stage 1 DN to the DN1 group, (2) 31 participants with stage 2 DN to the DN2 group, (3) 30 participants with stage 3 DN to the DN3 group, (4) 30 participants with stage 4 DN to the DN4 group, and (5) 29 participants with stage 5 DN to the DN5 group.
The research team measured participants' levels of "nucleotide binding oligomeric domain-like receptor protein 3" (NLRP3), interleukin-1 beta (IL-1β), and IL-18 and used the Spearman rank correlation analysis to determine the correlation between those levels and the DN stages.
The levels of NLRP3 , IL-1β and IL-18 in all the five observation groups were significantly higher than those in the control group (all P < .01). The levels were also significantly higher: (1) in the DN2, DN3, DN4, and DN5 groups than those in the DN1 group (all P < .01); (2) in the DN3, DN4, and DN5 groups than those in the DN2 group (all P < .01); (3) in the DN4 and DN5 groups than those in the DN3 group (all P < .01); and (4) in the DN5 groups than those in the DN4 group (all P < .01). The Spearman rank correlation analysis showed that the NLRP3, IL-1β, and IL-18 levels were significantly positively correlated with the DN stage (P = .01).
NLRP3, IL-1β and IL-18 played an important role in the progression of T2DM, and their levels increased with the aggravation of DN. Therefore, the plasma levels of NLRP3, IL-1β and IL-18 can be useful as indicators of the occurrence and development of DN and can provide clinical guidance for the early diagnosis of DN and for the determination and adjustment of treatment plans.
糖尿病肾病（DN）是糖尿病患者常见的微血管并发症。DN 的发病机制复杂，炎症反应可能作为共同的下游途径发挥关键作用。
本研究旨在探讨血浆核苷酸结合寡聚结构域样受体蛋白 3（NLRP3 炎性小体）、白细胞介素-1β（IL-1β）和白细胞介素-18 水平与 2 型糖尿病肾病进展的关系，阐明其与 2 型糖尿病（T2DM）的关系，为临床治疗提供依据。
研究团队进行了一项对照观察性研究。
研究在河北省保定市第一中心医院进行。
2020 年 10 月至 2021 年 10 月期间在医院接受治疗的 153 名 T2DM 患者。研究团队将 30 名无 DN 证据的参与者分配到对照组。根据 DN 分期，研究团队将其余 123 名参与者分配到五个观察组之一：（1）32 名 1 期 DN 患者归入 DN1 组；（2）31 名 2 期 DN 患者归入 DN2 组；（3）30 名 3 期 DN 患者归入 DN3 组；（4）30 名 4 期 DN 患者归入 DN4 组；（5）29 名 5 期 DN 患者归入 DN5 组。
研究团队测量了参与者的“核苷酸结合寡聚结构域样受体蛋白 3”（NLRP3）、白细胞介素-1β（IL-1β）和白细胞介素-18 水平，并采用 Spearman 秩相关分析来确定这些水平与 DN 分期之间的相关性。
五个观察组的 NLRP3、IL-1β 和 IL-18 水平均明显高于对照组（均 P <.01）。DN2、DN3、DN4 和 DN5 组的水平也明显高于 DN1 组（均 P <.01）；DN3、DN4 和 DN5 组的水平明显高于 DN2 组（均 P <.01）；DN4 和 DN5 组的水平明显高于 DN3 组（均 P <.01）；DN5 组的水平明显高于 DN4 组（均 P <.01）。Spearman 秩相关分析显示，NLRP3、IL-1β 和 IL-18 水平与 DN 分期呈显著正相关（P =.01）。
NLRP3、IL-1β 和 IL-18 在 T2DM 进展中起重要作用，其水平随 DN 的加重而升高。因此，血浆 NLRP3、IL-1β 和 IL-18 水平可作为 DN 发生和发展的有用指标，为 DN 的早期诊断以及治疗方案的确定和调整提供临床指导。
