Department of Endocrinology, People's Hospital of Chengyang District, Qingdao, China.
Department of Ultrasound, People's Hospital of Chengyang District, Qingdao, China.
Medicine (Baltimore). 2023 Sep 8;102(36):e35046. doi: 10.1097/MD.0000000000035046.
Diabetic kidney disease (DKD) was the leading cause of kidney disease, which has been a crucial public health. Liraglutide is a drug, widely used for DKD treatment globally. However, the extraglycemic inflammatory markers and renal hemodynamic parameters of DKD patients treated with liraglutide has been not reported. In this study, 160 patients with early DKD were enrolled, 80 cases in the control group and 80 cases in the treatment group, respectively. The individuals in the control group were treated with metformin, while the individuals in the treatment group were treated with liraglutide and metformin for 3 months. The urinary microalbumin and urinary creatinine was measured to calculate the ratio (UACR), while the Doppler ultrasound were measured before and after treatment. After 3 months of treatment, body mass index (BMI), waist circumference (WC) and low-density lipoprotein cholesterol (LDL) in the treatment group were significantly decreased compared with before and after treatment in the control group; the levels of cystatin and UACR in treatment group were lower than before treatment and control group; The end-diastolic blood flow velocity (EDV) of renal artery and segment artery in treatment group was significantly higher than that before treatment and control group; The levels of CRP, TNF-α and IL-6 in the treatment group after treatment were lower than those before treatment and those in the control group. After 3 months of treatment, blood cystatin in the treatment group decreased significantly compared with before treatment and after treatment in the control group, with statistical significance After 3 months of treatment, the EDV of renal artery and renal segment in treatment group was significantly higher than that before treatment and control group, the peak systolic blood flow velocity (PSV) and EDV of renal interlobar artery in treatment group were significantly higher than those before treatment and control group. The resistance index (RI) was significantly lower than that before treatment and control group. Liraglutide can reduce inflammatory indicators, renal artery blood flow and renal function indicators in early DKD patients.
糖尿病肾病（DKD）是导致肾脏疾病的主要原因，这已经成为一个重要的公共卫生问题。利拉鲁肽是一种药物，被广泛用于全球 DKD 的治疗。然而，利拉鲁肽治疗 DKD 患者的血糖外炎症标志物和肾脏血流动力学参数尚未见报道。本研究纳入了 160 例早期 DKD 患者，对照组 80 例，治疗组 80 例。对照组采用二甲双胍治疗，治疗组采用利拉鲁肽联合二甲双胍治疗 3 个月。检测尿微量白蛋白和尿肌酐，计算尿白蛋白/肌酐比值（UACR），治疗前后行多普勒超声检查。治疗 3 个月后，与对照组治疗前后比较，治疗组患者的体重指数（BMI）、腰围（WC）、低密度脂蛋白胆固醇（LDL）明显降低；治疗组胱抑素和 UACR 水平均低于治疗前及对照组；治疗组肾动脉和段动脉舒张末期血流速度（EDV）明显高于治疗前及对照组；治疗组治疗后 C 反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平均低于治疗前及对照组。治疗 3 个月后，治疗组患者血胱抑素水平明显低于治疗前及对照组治疗后，差异有统计学意义（P<0.05）。治疗 3 个月后，治疗组肾动脉和段动脉 EDV 明显高于治疗前及对照组，治疗组肾叶间动脉收缩期峰值血流速度（PSV）和 EDV 明显高于治疗前及对照组，阻力指数（RI）明显低于治疗前及对照组。利拉鲁肽能降低早期 DKD 患者的炎症指标、肾动脉血流及肾功能指标。
