• 제목/요약/키워드: Diabetic Kidney Disease

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Combination of canagliflozin and puerarin alleviates the lipotoxicity to diabetic kidney in mice

  • Qian Zhu;Qu Zhou;Xiao-li Luo;Xu-jie Zhang;San-yu, Li
    • The Korean Journal of Physiology and Pharmacology
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    • 제27권3호
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    • pp.221-230
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    • 2023
  • Diabetic kidney disease is one of the most serious complications of diabetes. Although diabetic kidney disease can be effectively controlled through strict blood glucose management and corresponding symptomatic treatment, these therapies cannot reduce its incidence in diabetic patients. The sodium-glucose cotransporter 2 (SGLT2) inhibitors and the traditional Chinese herb "Gegen" have been widely used in diabetes-related therapy. However, it remains unclear whether the combined use of these two kinds of medicines contributes to an increased curative effect on diabetic kidney disease. In this study, we examined this issue by evaluating the efficacy of the combination of puerarin, an active ingredient of Gegen, and canagliflozin, an SGLT2 inhibitor for a 12-week intervention using a mouse model of diabetes. The results indicated that the combination of puerarin and canagliflozin was superior to canagliflozin alone in improving the metabolic and renal function parameters of diabetic mice. Our findings suggested that the renoprotective effect of combined puerarin and canagliflozin in diabetic mice was achieved by reducing renal lipid accumulation. This study provides a new strategy for the clinical prevention and treatment of diabetic kidney disease. The puerarin and SGLT2 inhibitor combination therapy at the initial stage of diabetes may effectively delay the occurrence of diabetic kidney injury, and significantly alleviate the burden of renal lipotoxicity.

당뇨병 환자의 당뇨성 안질환 및 신장질환 합병증 검사 수검 여부에 영향을 주는 요인 (Factors affecting Diabetic Eye disease and Kidney disease Screening in Diabetic Patients)

  • 강정희
    • 한국산학기술학회논문지
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    • 제21권4호
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    • pp.226-235
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    • 2020
  • 연구목적은 당뇨성 안질환 및 신장질환 합병증 검사 수검여부에 영향을 주는 요인을 알아보기 위함이다. 본 연구는 2017년 지역사회 건강조사 전국 자료를 이용하였으며, 연구대상은 의사에게 당뇨병을 진단받은 적이 있다고 응답한 사람 25,829명이다. 당뇨병 환자의 당뇨성 안질환 및 신장질환 합병증 검사 수검여부에 영향을 주는 요인을 알아보기 위해 로지스틱 회귀분석을 실시하였다. 연구결과는 당뇨병 환자 중 당뇨성 안질환 합병증 검사 수검율은 35.6%, 당뇨성 신장질환 합병증 검사 수검률은 39.8%이었다. 걷기실천을 할수록(OR=1.03, OR=1.02), 당화혈색소(OR=2.33, OR=2.33) 및 혈당수치(OR=1.61, OR=1.71)를 인지하는 사람과 현재 당뇨병 치료(OR=2.67, OR=3.05) 및 당뇨병 관리교육(OR=1.45, OR=1.47)을 받는 사람의 당뇨성 안질환 및 신장질환 합병증 검사를 받을 가능성이 많았다. 결론적으로 당뇨성 합병증 검사 수검율을 높이기 위해서는 당뇨병 환자를 대상으로 당뇨성 합병증 검사의 종류와 검사 시기가 포함된 당뇨병 관리 교육체계와 당화혈색소 및 혈당수치를 인지시킬 수 있는 다양한 홍보 방법 등이 개발되어야 할 것으로 생각된다. 그리고 당뇨병 관리를 위한 가이드라인 개발하고, 국가차원에서 국가검진제도에 당뇨성 합병증 검사 선별검사항목을 포함하는 등 시스템이 필요할 것으로 보인다.

Role of Reactive Oxygen Species in High Glucose-induced Tissue Injury

  • Hunjoo Ha;Lee, Hi-Bahl
    • 한국생물물리학회:학술대회논문집
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    • 한국생물물리학회 2001년도 학술 발표회 진행표 및 논문초록
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    • pp.25-25
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    • 2001
  • Diabetes is the leading cause of end-stage renal disease worldwide. In Korea, diabetic kidney disease accounted for 39% of all new dialysis patients in 1998. Diabetic nephropathy is characterized by glomerular hyperfiltration, albuminuria, and expansion of glomerular mesangium. Since glomerular mesangial cells regulate glomerular filtration rates and are capable of producing extracellular matrix (ECM) proteins, the functional abnormalities of mesangial cells under diabetic milieu play an important role in the development and progression of diabetic nephropathy.(omitted)

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당뇨병성 신장질환 환자에서 적정 혈압 관리의 중요성 (Importance of Target Blood Pressure Management in Diabetic Kidney Disease)

  • 김희성
    • 한국콘텐츠학회논문지
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    • 제19권6호
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    • pp.461-470
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    • 2019
  • 신장질환은 당뇨병환자에서 흔한 합병증이며, 알부민뇨 배설의 증가, 사구체여과율의 감소가 특징적이다. KDIGO 분류에 따라 6기 국민건강영양조사 원시자료를 이용하여 알부민뇨와 사구체여과율에 따라 특성을 분석하였다. 당뇨환자를 KDIGO의 분류에 따라, Low risk 72.0%, Moderate risk 19.3%, High risk 5.6%, Very high risk 3.0%이었다. 당뇨병 유병기간이 길어질수록 Low risk는 74.7%에서 52.2%로 감소하였고, Moderate~Very high risk는 25.4%에서 47.8%로 상승하였다. 위험요인은 CKD stage 1 (HR 2.064) ~ stage 4 (HR 11.049)로 고혈압의 위험도가 가장 높았다. 고혈압 유병기간에 따라 신장질환의 발생빈도는 상승하였고, 적정 혈압을 유지하는 군에서 신장질환의 위험도 0.42가 감소하였다. 고혈압 환자에서 적정 혈압으로 관리하는 군이 그렇지 않은 군보다 42%의 신장질환의 감소효과가 있었다. 그러므로 고혈압을 적정혈압으로 조절 및 관리하는 것이 신장질환의 예방에 있어 중요하다.

Differential Expression of Kidney Proteins in Streptozotocin-induced Diabetic Rats in Response to Hypoglycemic Fungal Polysaccharides

  • Hwang, Hye-Jin;Baek, Yu-Mi;Kim, Sang-Woo;Kumar, G. Suresh;Cho, Eun-Jae;Oh, Jung-Young;Yun, Jong-Won
    • Journal of Microbiology and Biotechnology
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    • 제17권12호
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    • pp.2005-2017
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    • 2007
  • Diabetic nephropathy remains a major cause of morbidity and mortality in the diabetic population and is the leading cause of end-stage renal failure. Despite current therapeutics including intensified glycemic control and blood pressure lowering agents, renal disease continues to progress relentlessly in diabetic patients, albeit at a lower rate. Since synthetic drugs for diabetes are known to have side effects, fungal mushrooms as a natural product come into preventing the development of diabetes. Our previous report showed the hypoglycemic effect of extracellular fungal polysaccharides (EPS) in streptozotocin (STZ)-induced diabetic rats. In this study, we analyzed the differential expression patterns of rat kidney proteins from normal, STZ-induced diabetic, and EPS-treated diabetic rats, to discover diabetes-associated proteins in rat kidney. The results of proteomic analysis revealed that up to 500 protein spots were visualized, of which 291 spots were differentially expressed in the three experimental groups. Eventually, 51 spots were statistically significant and were identified by peptide mass fingerprinting. Among the differentially expressed renal proteins, 10 were increased and 16 were decreased significantly in diabetic rat kidney. The levels of different proteins, altered after diabetes induction, were returned to approximately those of the healthy rats by EPS treatment. A histopathological examination showed that EPS administration restored the impaired kidney to almost normal architecture. The study of protein expression in the normal and diabetic kidney tissues enabled us to find several diabetic nephropathy-specific proteins, such as phospholipids scramblase 3 and tropomyosin 3, which have not been mentioned yet in connection with diabetes.

Upstream Regulators and Downstream Effectors of NADPH Oxidases as Novel Therapeutic Targets for Diabetic Kidney Disease

  • Gorin, Yves;Wauquier, Fabien
    • Molecules and Cells
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    • 제38권4호
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    • pp.285-296
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    • 2015
  • Oxidative stress has been linked to the pathogenesis of diabetic nephropathy, the complication of diabetes in the kidney. NADPH oxidases of the Nox family, and in particular the homologue Nox4, are a major source of reactive oxygen species in the diabetic kidney and are critical mediators of redox signaling in glomerular and tubulointerstitial cells exposed to the diabetic milieu. Here, we present an overview of the current knowledge related to the understanding of the role of Nox enzymes in the processes that control mesangial cell, podocyte and tubulointerstitial cell injury induced by hyperglycemia and other predominant factors enhanced in the diabetic milieu, including the renin-angiotensin system and transforming growth factor-${\beta}$. The nature of the upstream modulators of Nox enzymes as well as the downstream targets of the Nox NADPH oxidases implicated in the propagation of the redox processes that alter renal biology in diabetes will be highlighted.

Diabetic Nephropathy - a Review of Risk Factors, Progression, Mechanism, and Dietary Management

  • Natesan, Vijayakumar;Kim, Sung-Jin
    • Biomolecules & Therapeutics
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    • 제29권4호
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    • pp.365-372
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    • 2021
  • Type 2 diabetes mellitus (T2DM) leads to many health problems like diabetic nephropathy (DN). One of the key factors for chronic kidney disease and end-stage renal disease (ESRD) is T2DM. Extensive work is being done to delineate the pathogenesis of DN and to extend possible remedies. This review is intended to understand the nature of DN risk factors, progression, effects of glycemic levels, and stages of DN. We also explored the novel diagnostic and therapeutic approaches for DN such as gene therapy and stem cell treatments.

갈근이 고지방·고탄수화물식이와 저용량 streptozotocin-유도 당뇨병 마우스에 미치는 효능 연구 (Effect of the root extract of Pueraria thunbergiana Bentham on high fat/high sucrose diet and single low-dose streptozotocin-induced diabetic mice)

  • 오태우;박용기
    • 대한본초학회지
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    • 제29권5호
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    • pp.75-81
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    • 2014
  • Objectives : This study was performed to investigate the effect of root extract of Pueraria thunbergiana Bentham (Puerariae Radix, PR) in diabetic mice as similar as emaciation-thirst disease in Oriental medicine. Methods : C57BL/6 mice were fed high fat (HF) and high sucrose (HS) for 8 weeks, and then administrated with 90 mg/kg body weight (bw) of streptozotocin (STZ) for induction of diabetes which is similar to the middle emaciation stage. After 5 days, blood glucose levels were measured, and selected the mice with ranges above $250mg/d{\ell}$. PR water extract was administrated orally once a day for 4 weeks with high fat and high sucrose. The levels of glucose, insulin, total cholesterol, triglyceride, ${\gamma}glutamyl$ transpeptidase (${\gamma}GTP$), glutamic oxaloacetic transaminase (GOT) and glutamate pyruvate transaminase (GPT) were analysed in the serum. Also, observed their histological changes by hematoxylin and eosin (H&E) of different organs, lung, heart, pancreas, stomach, liver, and kidney. Results : PR extract significantly decreased the levels of serum glucose and insulin in diabetic mice. PR extract significantly increased the levels of triglyceride, total cholesterol, GOT and GPT in diabetic mice. In H&E stain, PR extract inhibited the histopathological changes of lung (as a channel of the upper emaciation stage in the channel-tropism theory), pancreas (as a channel of the middle emaciation stage) and kidney (as a channel of the lower emaciation stage) in diabetic damage. Conclusions : PR extract has an anti-diabetic effect in HF/HS and low-dose STZ-induced diabetic mice. This result suggests that PR follows the channel-tropism theory in the emaciation-thirst disease through the protection of lung, pancreas and kidney.

Effects of Chungkookjang on Blood Glucose, Antioxidant Enzyme Activities and Histological Changes in Kidney of STZ-induced Diabetic Rats

  • Kim, Hye-Jeong;Kim, Young-Chul
    • 대한의생명과학회지
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    • 제14권4호
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    • pp.211-218
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    • 2008
  • The purpose of this study was to investigate the effects of dietary Chungkookjang (Korean fermented soybean) powder on blood glucose level, lipid profiles, antioxidant enzymes activities and histological changes in kidney of streptozotocin (STZ)-induced diabetic rats. Male Sprague-Dawley rats of three groups including nondiabetic group fed normal diet (NC), diabetic group fed normal diet (DC) and diabetic group fed Chungkookjang diet (DCH; 100 g/kg diet) were reared for 8 weeks. The serum glucose, triglycelide and total lipid levels in the DCH group were significantly lower (P<0.05) than the DC group. The renal xanthine oxidase, catalase and glutathione S-transferase activities in the DC group were significantly higher than the NC group. The xanthine oxidase, superoxide dismutase and glutathione S-transferase activities in the DCH group were significantly lower than the DC group (P<0.05). Tubular epithelial change, such as Armanni-Ebstein cells, was significantly reduced in the DCH group compared to the DC group. In conclusion, these results indicated that Chungkookjang supplement seems to be beneficial to correct the hyperglycemia and hyperlipidemia as well as to protect kidney against diabetic changes.

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스트렙토조토신-당뇨쥐에서 지질과산화 및 항산화계의 경시적 변화 (Changes in in vivo Lipid Peroxidation and Antioxidant Defense System in Streptozotocin-Induced Diabetic Rats: a Time Course Study)

  • 이수자;박수현;이혜성
    • Journal of Nutrition and Health
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    • 제34권3호
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    • pp.253-264
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    • 2001
  • This study was carried out to examine a part of the mechanism for the etiology of diabetic complications. Thirty normal and forty streptozotocin(STZ)-induced diabetic rats were used as the animal models. The animals were sacrificed at the time points of 3 days, 1,2,4 and 6 weeks after STZ-injection and a time course changes in the concentrations of thiobarbituric acid-reactive substances(TBARS) in blood, urine, and tissues, along with the levels of conjugated dienes in tissues were measured as indices of in vivo lipid peroxidation. The activities of antioxidant enzymes, catalase, superoxide dismutase, glutathione peroxidase and the levels of blood retinol and alpha-tocopherol were also measured. The diabetic rats maintained a slightly higher plasma TBARS level throughout the experiment. The urinary TBARS level was significantly higher in diabetic group and gradually increased with time. Concentrations of TBARS in liver, heart, and kidney tissues from diabetic animals were higher than those from the normal group. An increase of conjugated dienes was also observed in the all tissues examined. The kidney tissue of diabetic animals revealed more significant lipid peroxidation state than any other organ tissues. The activities of hepatic antioxidant enzymes such as catalase, superoxide dismutase, glutathione peroxidase were higher in diabetic animals compared to the control ones and increased with the duration of diabetes mellitus. The plasma levels of vitamin A and E were loser in diabetic animals than in normal controls throughout the experimental period. The level of vitamin E in diabetic animals was significantly decreased with the duration of the disease. The results of this study suggest that an effective regimen to suppress the adverse changes in lipid peroxidation and antioxidant defense system is required from the early stage of the disease to prevent the development of diabetic complications. (Korean J Nutrition 34(3) : 253∼264, 2001)

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