Chen Shumei, He Meiqing, Qin Yufan, Tian Jing, Liang Zerong, Li Ying, Wang Peihua, Zhang Youzhi, Zhou Cui, Xiao Juan
Department of Endocrinology of Chongqing Red Cross Hospital (People's Hospital of Jiangbei District), Chongqing, China.
Medicine (Baltimore). 2024 Nov 22;103(47):e40438. doi: 10.1097/MD.0000000000040438.
This study evaluates the effects of liraglutide on albuminuria, oxidative stress, and inflammation in type 2 diabetes (T2D) patients with different urinary albumin-to-creatinine ratio (UACR) categories. We enrolled 107 patients with T2D who were initiating liraglutide for glycemic control. Patients were categorized into 3 groups: group I (UACR < 30 mg/g); group II (30 mg/g ≤ UACR ≤ 300 mg/g); group III (UACR > 300 mg/g). We observed the changes in body mass index, fasting plasma glucose, glycated hemoglobin, lipid profile, serum liver enzymes, creatinine, uric acid, cystatin C, UACR, as well as oxidative stress and inflammation biomarkers such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), monocyte chemotactic protein-1 (MCP-1), malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase before and after 3 months of liraglutide treatment. After 3-month liraglutide treatment, fasting plasma glucose, glycated hemoglobin, and body mass index significantly decreased in all 3 groups regardless of the baseline UACR (all P < .05). UACR significantly decreased in groups II (P = .005) and III (P = .001). Patients with higher UACR at baseline showed significantly greater albuminuria reduction (P < .001). Compared with baseline, TNF-α, IL-6, MCP-1, and MDA were remarkably decreased, while SOD and glutathione peroxidase were significantly increased in all 3 groups (P < .05). UACR at baseline showed a positive correlation with TNF-α, IL-6, and MDA, and a negative correlation with SOD at baseline. The change in UACR was negatively correlated with UACR, TNF-α, and MDA at baseline, while it was positively correlated with SOD at baseline, and also positively correlated with the change in MCP-1. Liraglutide ameliorated albuminuria in T2D patients with microalbuminuria and macroalbuminuria. The renoprotective effect of liraglutide was associated with the alleviation of oxidative stress and inflammation. These findings may provide new therapeutic strategies for patients with diabetic kidney disease.
本研究评估了利拉鲁肽对不同尿白蛋白与肌酐比值（UACR）类别的2型糖尿病（T2D）患者蛋白尿、氧化应激和炎症的影响。我们纳入了107例开始使用利拉鲁肽进行血糖控制的T2D患者。患者被分为3组：I组（UACR<30mg/g）；II组（30mg/g≤UACR≤300mg/g）；III组（UACR>300mg/g）。我们观察了利拉鲁肽治疗3个月前后体重指数、空腹血糖、糖化血红蛋白、血脂谱、血清肝酶、肌酐、尿酸、胱抑素C、UACR以及氧化应激和炎症生物标志物如肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、单核细胞趋化蛋白-1（MCP-1）、丙二醛（MDA）、超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶的变化。利拉鲁肽治疗3个月后，无论基线UACR如何，所有3组患者的空腹血糖、糖化血红蛋白和体重指数均显著降低（均P<.05）。II组（P=.005）和III组（P=.001）的UACR显著降低。基线时UACR较高的患者蛋白尿减少更为显著（P<.001）。与基线相比，所有3组患者的TNF-α、IL-6、MCP-1和MDA均显著降低，而SOD和谷胱甘肽过氧化物酶显著升高（P<.05）。基线时UACR与TNF-α、IL-6和MDA呈正相关，与SOD呈负相关。UACR的变化与基线时的UACR、TNF-α和MDA呈负相关，与基线时的SOD呈正相关，也与MCP-1的变化呈正相关。利拉鲁肽改善了微量白蛋白尿和大量白蛋白尿的T2D患者的蛋白尿。利拉鲁肽的肾脏保护作用与氧化应激和炎症的减轻有关。这些发现可能为糖尿病肾病患者提供新的治疗策略。
