Postprandial Glycemic Control Conditions in Relation to UrinaryN-Acetyl-β-d-Glucosaminidase in Patients with Type 2 Diabetes Mellitus Without Low Glomerular Filtration Rate

2014 ◽  
Vol 16 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Motoshi Ouchi ◽  
Kenzo Oba ◽  
Masayuki Motoyama ◽  
Misako Tsunoda ◽  
Hidetoshi Yamashita ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Glycemic Control ◽  
Glomerular Filtration ◽  
Filtration Rate

MO640LASER DOPPLER FLOWMETRY IN STUDYING OF MICROVASCULAR DISORDERS IN PATIENTS WITH DIABETIC NEPHROPATHY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Petr Vasilev ◽  
Alexander Shishkin ◽  
Nikolai Erofeev ◽  
Mikhail Erman ◽  
Ivan Pchelin
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Doppler Flowmetry

Abstract Background and Aims According to various research, vascular complications of type 2 diabetes mellitus are the main reason for patients' mortality. The most specific one, observed in patients with diabetes only, is diabetic microangiopathy, especially diabetic nephropathy. This complication accounts for more than 20% of cases of chronic kidney disease. So, the development of non-invasive methods for the diagnosis of vascular complications of type 2 diabetes mellitus is critically important. There is a perspective method for this problem - Laser Doppler flowmetry (LDF). It is currently used in the diagnosis of diabetic microangiopathy, but the limiting factor is the lack of a unified algorithmic approach to the data interpretation. This work aimed to analyze changes in the amplitude indicators of the low-frequency part of the LDF signal spectrum in patients with chronic kidney disease and type 2 diabetes and to identify their correlations with the glomerular filtration rate. Method The study included 42 patients (20 men and 22 women) with type 2 diabetes mellitus chronic kidney disease (stage C3-C4). The age of patients was 58-77 years (66 years on average). The duration of diabetes was more than 5 years (on average 7 years). All patients had diabetic nephropathy with a decrease in glomerular filtration rate, chronic kidney disease stage C3-C4. Laser Doppler flowmetry was done using the "LAZMA MC-1" system ("Lazma", Russia). Each patient had a 10-minute LDF registration. The sensor was placed on the skin of the rear of the foot. After recording the LDF curve, the special software has calculated amplitudes of endothelial, myogenic, neurogenic, respiratory, and pulse flux motions. Then we assessed the amplitude contribution of every frequency range to the total power of the local flux motion region. The next step was a correlation analysis with the estimated glomerular filtration rate. For statistical analysis, we used the GraphPad Prism 8 (GraphPad Software, USA). Results All examined patients had amplitude peaks in the neurogenic, myogenic, respiratory, and pulse ranges. There were no significant correlations between the glomerular filtration rate and the amplitudes of myogenic and neurogenic flux motions (p>0.05) (Fig. 1). However, there was a significant positive correlation between the contribution of myogenic flux motions to the low-frequency range and glomerular filtration rate (p<0.01), and a negative one – for the contribution of neurogenic flux motions (p<0.01) (Fig. 2). In six observations there was a tendency to a decrease in the contribution of endothelial flux motions as the glomerular filtration rate decreased. Conclusion The results of this study showed that laser Doppler flowmetry has the potential to diagnosis the nature of the dysfunction of individual microcirculation modulation mechanisms. In patients with chronic kidney disease of the C3-C4 stage decreasing the glomerular filtration rate correlated with decreasing the contribution of myogenic flux motions and increasing the contribution of neurogenic flux motions to the total power of the low-frequency part of the LDF signal amplitude-frequency spectrum. These changes can be explained within the framework of the existing understanding of the pathogenesis of diabetic microangiopathy, namely, damage to the smooth muscle layer of the wall of arterioles and venules with damage to myocyte pacemakers and changes of basal vascular tone pattern. It causes an increase in the role of neurogenic modulation of the micro-vascular bloodstream. These data can be an additional argument in favor of the further development of improving laser Doppler flowmetry using for the tasks of early (preclinical) non-invasive diagnosis of microvascular disorders in patients with type 2 diabetes mellitus, as well as for monitoring the effectiveness of the therapy. The reported study was funded by RFBR, project number 19-315-90080.

scholarly journals Risk Factors for Cardiovascular and Renal Disease in Type 2 Diabetes Mellitus in Patients with Normal and Mildly Reduced Glomerular Filtration Rate

2021 ◽  
Vol 18 (2) ◽  
pp. 61-68
Author(s):  
Marcel Stoiţă ◽  
Amorin Remus Popa
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Glomerular Filtration ◽  
Filtration Rate

Abstract In this study are investigated the cardiovascular risk factors that as shown in literature also represent risk factors for early glomerular function alteration in type 2 diabetes mellitus patients. The patients were divided according to their glomerular filtration rate in 2 groups, one group of patients with GFR ≥90 mL/min/1.73 m (118 patients) and the other with GFR between 60-89 mL/min/1.73 m2 (126 patients). Older age, hypertension, poor glycemic control, increased BMI, high LDL-cholesterol, high triglyceride level, insulin resistance and high level of apolipoprotein-B appeared to be more prevalent in patients with type 2 diabetes mellitus with mildly reduced kidney function. Even patients with mildly reduced GFR (without confirmed diabetic kidney disease) have an important aggregation of cardiovascular risk factors and their early identification is important for controlling them in order to further prevent glomerular decline.

scholarly journals Arterial Stiffness Is More Associated with Albuminuria than Decreased Glomerular Filtration Rate in Patients with Type 2 Diabetes Mellitus: The REBOUND Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jong Ho Kim ◽  
Sang Soo Kim ◽  
In Joo Kim ◽  
Bo Hyun Kim ◽  
Ja Young Park ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glomerular Filtration Rate ◽  
Arterial Stiffness ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Univariate Analysis ◽  
Clinical Variables

Aim. The aim of this study was to evaluate the association between arterial stiffness and albuminuria and glomerular filtration rate (GFR) in patients with type 2 diabetes mellitus. Methods. This multicenter cohort study analyzed 2613 patients with type 2 diabetes. Brachial-ankle pulse wave velocity (baPWV) was used as a noninvasive marker of arterial stiffness. Additionally, the patients were categorized into four groups according to their albumin-to-creatinine ratio (ACR, normoalbuminuria versus albuminuria) and estimated GFR (eGFR, <60 mL/min/1.73 m2 versus ≥60 mL/min/1.73 m2). Results. A univariate analysis revealed that maximal baPWV was significantly associated with both the ACR (r=0.297, P<0.001) and eGFR (r=−0.220, P<0.001). A multivariate analysis adjusted for significant clinical variables and eGFR showed that baPWV remained significantly correlated with the ACR (r=0.150, P<0.001). Also, baPWV was correlated positively with the ACR in patients with an eGFR ≥ 60 mL/min/1.73 m2 (r=0.146, P<0.001). However, baPWV was not correlated with eGFR after adjustment for significant clinical variables. Conclusions. The present findings indicate that arterial stiffness is more associated with albuminuria than a decrease in GFR in patients with type 2 diabetes mellitus.

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