• Title/Summary/Keyword: Diabetic Nephropathy

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Correlation of advanced glycation end products and heme oxygenase-1 in Korean diabetic patients (제2형 당뇨병 환자에서 최종당화산물과 heme oxygenase-1의 상관성)

  • Choi, Ha-Neul;Koo, Da-Hye;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.55 no.3
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    • pp.348-358
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    • 2022
  • Purpose: Hyperglycemia accelerates the formation of advanced glycation end products (AGEs), a group of compounds formed via non-enzymatic glycation/glycoxidation. Type 2 diabetes mellitus (T2DM) is related to oxidative stress, resulting in some overgeneration of AGEs. The accumulation of AGEs in T2DM patients leads to increased inflammation, DNA damage, tissue damage, progression of diabetic microvascular disease, and nephropathy. Heme oxygenase-1 (HO-1) is an intracellular enzyme that catalyzes the oxidation of heme. Expression of HO-1 in the endothelium and in muscle monocytes/macrophages was upregulated upon exposure to reactive oxygen species or oxidized low-density lipoprotein. Cells activated by oxidative stress are reported to release HO-1 in the serum. In the current study, we discuss the oxidative status according to the level of AGEs and the association of HO-1 with AGEs or urinary DNA damage marker in type 2 diabetic Korean patients. Methods: This study enrolled 36 diabetic patients. Subjects were classified into two groups by serum AGEs level (Low AGEs group: < 0.85 ng/mL serum AGEs; High AGEs group: ≥ 0.85 ng/mL serum AGEs). Body composition was measured using bioelectrical impedance analysis. Blood and urinary parameters were measured using commercial kits. Results: No significant differences were observed in the general characteristics and body composition between the two groups. Serum HO-1 concentration was significantly higher in the High AGEs group than in the Low AGEs group. After adjustment of age and gender, a correlation was performed to assess the association between serum HO-1 and serum AGEs or urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG). Our results indicate that serum HO-1 is positively correlated with serum AGEs and urinary 8-OHdG. Conclusion: Taken together, our results indicate that in diabetes patients, a high level of HO-1 is associated with a high concentration of AGEs and 8-OHdG, probably reflecting a protective response against oxidative stress.

The Effect of Yookmijihwang-tang(Yookmijihwang-tang:YJT) on Mice with Diabetic Nephropathy Induced by Alloxan (육미지황탕(六味地黃湯)이 Alloxan으로 유발(誘發)된 생쥐의 당뇨병성(糖尿病性) 신증(腎症)에 미치는 영향(影響))

  • Kim, Yong-Sung;Seo, Soo-Hwan
    • The Journal of Internal Korean Medicine
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    • v.26 no.4
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    • pp.741-752
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    • 2005
  • This study was done to investigate recovery effects of YJT, which has been used clinically in diabetes therapy. Mice were administerd Alloxan to induce diabetes. There body weight and kidney weight changes, BUN, creatinine, glucose, total protein and ALP activity in serum, urinalysis, excretion volume of Na+, K+ in urine were measured. The results were as follows: 1. Increase in body weight and kidney weight and the ratio of kidney to body weight of YJT treated group showed similar results with those of normal group. 2 The BUN, creatinine, ALP activity levels in serum of YJT treated group were similar with those of normal group. 3. The glucose level in serum of YJT treated group was better than that of control group 4. The result of the urinalysis in the group of YJT was almost same as that of control group The above results suggest that YJT partially improves the function of the kidney.

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Total Cholesterol and Alkaline Phosphatase are Increased in D/D Type of Angiotensin Converting Enzyme

  • Kim, Sung-Su
    • Biomedical Science Letters
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    • v.18 no.4
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    • pp.406-412
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    • 2012
  • The polymorphism (insertion, I or deletion, D) of angiotensin converting enzyme (ACE) gene is designated as the presence of a 287 bp Alu repeat. The D/D homozygote carrier is associated with high ACE activity, and this high activity has been implicated with hypertension, coronary artery disease, or diabetic nephropathy. We studied the clinical candidate marker in ACE gene polymorphism using chemical and hematological analysis. The subjects are divided into normotensive and hypertensive groups and ACE genotype in the group was confirmed by PCR method. Chemical analysis was preceded with Hitachi7060, and hematological analysis was performed using Mythic 22. In 116 targeted people, 17 (38.64%) of 44 I/I genotype group are hypertension, 15 (34.09%) in 44 with D/I, but, D/D type in the 28 cases is 15 patients (53.57%) in hypertension. In hypertension group, biochemical analysis (triglyceride, and alkaline phosphatase) and hematological analysis (white blood cell, platelet) are showed high value in D/D genotype of ACE gene. The relationship between hypertension and ACE genotype is the same results as previously reported and we thought that the high laboratory value of white blood cell, platelet, triglycerides, and alkaline phosphatase are also indicator of hypertension in D/D type of ACE.

High Glucose and Advanced Glycosylation Endproducts(AGE) Modulate the P-cadherin Expression in Glomerular Epithelial Cells(GEpC) (배양한 사구체 상피세포에서 고농도 당과 후기 당화합물에 의한 P-cadherin의 변화)

  • Ha Tae-Sun;Koo Hyun-Hoe;Lee Hae-Soo;Yoon Ok-Ja
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.119-127
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    • 2005
  • Purpose : Podocytes are critical in maintaining the filtration barrier of the glomerulus and are dependent on the integrity of slit diaphragm(SD) proteins including nephrin, p-cadherin, and others. Diabetic proteinuric condition demonstrates defects in SD molecules as well as ultrastructural changes in podocytes. We examined the molecular basis for this alteration of SD molecules especially on P-cadherin as a candidate regulating the modulation of pathogenic changes in the barrier to protein filtration. Methods : To investigate whether high glucose and AGE induce changes in SD, we cultured rat GEpC under normal(5 mM) or high glucose(30 mM) and AGE- or BSA-added conditions and measured the change of P-cadherin expression by Western blotting and RT-PCR. Results : We found that administration of high glucose decreased the P-cadherin production significantly in the presence or absence of AGE by Western blotting. In RT-PCR high glucose with or without AGE also significantly decreased the expression of P-cadherin mRNA compared to those of controls. Such changes were not seen in the osmotic control. Conclusion : We suggest that high glucose with or without AGE suppresses the Production of P-cadherin at the transcriptional level and that these changes nay explain the functional changes of SD in diabetic conditions. (J Korean Soc Pediatr Nephrol 2005;9:119-127)

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Chlorogenic Acid Isomers from Sorbus commixta of Ulleung Island Origin and Their Inhibitory Effects against Advanced Glycation End Product (AGE) Formation and Radical Scavenging Activity (울릉 마가목의 클로로겐산 이성체의 최종당화산물의 생성 저해 및 라디칼 소거 활성)

  • Kim, Tae Hoon
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.45 no.8
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    • pp.1208-1213
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    • 2016
  • Advanced glycation end product (AGE) formation and reactive oxygen species are potential therapeutic targets for the prevention of diabetic nephropathy and other pathogenic complications. Activity-guided isolation of an ethylacetate-soluble portion of 80% methanolic extract from fruits of Sorbus commixta of the Ulleung Island origin using AGE formation inhibition assay led to the isolation and identification of three caffeoylquinic acid derivatives of a previously known structure, 3-O-caffeoylquinic acid (neochlorogenic acid; 1), 4-O-caffeoylquinic acid (cryptochlorogenic acid; 2), and 5-O-caffeoylquinic acid (chlorogenic acid; 3). The structures of these compounds were confirmed by interpretation of nuclear magnetic resonance and mass spectrometry data. Among the isolates, the major metabolite, neochlorogenic acid (1) showed the most potent inhibitory effect against AGE formation with an $IC_{50}$ value of $167.5{\pm}3.5{\mu}M$. Furthermore, all isolated chlorogenic acid isomers were evaluated for their radical scavenging activity against peroxynitrite, and structurally related isomers 1, 2, and 3 exhibited potent inhibitory effects in this radical scavenging assay. This result suggests that the monocaffeoyl quinic acid derivatives isolated from S. commixta might be beneficial for the regulation of diabetic complications and related diseases.

A Study on the Circadian Blood Pressure Rhythm of Diabetic Patients (당뇨병 환자의 혈압 일주기 리듬에 관한 조사연구)

  • 김화순;서화숙
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.741-749
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    • 2000
  • This study was performed to investigate the relationship between reversed circadian blood pressure and risk factors of peripheral vascular disease in non-insulin-dependent diabetes mellitus (NIDDM) subjects. The subjects in this study were 18 NIDDM patients who were hospitalized in a medical unit of an university medical center located in Incheon, Korea, between November, 1998 and March, 1999. Blood pressure was measured with a mercury sphygmomanometer by 2 trained examiners every 2 hours during 24 hours. NIDDM subjects were divided into a dipper group and non-dipper group. Dippers are defined as those who show a mean nighttime blood pressure(BP) drop of more than 10% compared with daytime BP. Non-dippers are defined as those who show a mean nighttime BP drop of less than 10%, or an elevation in BP compared with daytime BP. Daytime BP included values obtained between 6 a.m. and 10 p.m. Night time BP included values obtained between 10 p.m. and 6 a.m. Data was analyzed by SPSS/PC package. Chi-square( $^2$) test was used for the comparison of sex between The dipper group and non-dipper group. Mann-Whitney test was used for comparisons of values of the risk factors of peripheral vascular disease and the frequency of complications of diabetes between the dipper group and non-dipper group. The results are as follows. There were no significant differences in daytime systolic, diastolic, and mean blood pressures between the dipper group and non-dipper group. However, night time systolic, diastolic, and mean blood pressures in the non-dipper group were significantly nigher than those in the dipper group (p=.021). There were no differences in sex, age, body, weight, duration of diabetes, serum lipid levels, BUN and HbA1c between the two groups. On the contrary, 87.5% of non-dipper group subjects showed having hypertension, 30% of dipper group subjects showed having hypertension and this difference was statistically significant (p=.018). All of the non-dipper group subjects (N=8) showed having at least one diabetic complication. However, 40% of the dipper group subjects (N=10) showed having no diabetic complication at all and this difference was also statistically significant (p=.049). There were no significant differences in frequency of nephropathy, neuropathy and retinopathy between the dipper group and non-dipper group.

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A Case Report of Diabetic Hyperlipidemia in a Patient with Cerebral Infarction Treated with Ojeok-san (뇌경색 환자의 당뇨병성 고지혈증에 대한 오적산가감방(五積散加減方) 호전 1례)

  • Han, Seung-Hea;Jeong, Byeong-Ju;Woo, Sung-Ho;Kim, Byung-Chul;Kim, Yong-Ho;Seo, Ho-Seok;Hwang, Gyu-Dong;Cho, Cheol-Jun;Nam, Hyo-Ick;Kim, Jin-Won
    • The Journal of Internal Korean Medicine
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    • v.26 no.1
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    • pp.275-280
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    • 2005
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and well-documented modifiable risk factors of stroke, especially of the ischemic type. For Insulin-Dependent Diabetes Mellitus sufferers, if blood sugar is appropriately maintained, lipid and lipoprotein are normal, but if blood sugar is inappropriately maintained or clinical Diabetic nephropathy induces metabolic disorder of lipid, then Total cholesterol, low density lipoprotein cholesterol, triglyceride and very low density lipoprotein cholesterol levels go up and high density lipoprotein levels go down. The purpose of this study is to evaluate the effect of treatment with Ojeok-san and to observe the changes in Fasting Blood Sugar(FBS), 2 Hours Postprandial Blood Sugar(PP2h), Haemoglobin A1c(HbA1c), Total Cholesterol(T-Chol) and Triglyceride(TG). After the treatment, Fasting Blood Sugar decreased from 149mg/dl to 89mg/dl. 2 Hours Postprandial Blood Sugar decreased from l85mg/dl to 110mg/dl. Haemoglobin A1c decreased from 6.3% to 5.7%. Total Cholesterol decreased from 268mg/dl to 217mg/dl. And Triglyceride decreased from 438mg/dl to 265mg/dl. These results support a role for oriental medical therapy in treating Diabetic Hyperlipidemia. Further case studies of herbal treatment of this ailment are needed.

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The Level of Diabetes Management of Agriculture, Forestry, and Fishery Workers (농림어업인의 당뇨병 관리 수준)

  • Oh, Gyung-Jae;Lee, Young-Hoon
    • Journal of agricultural medicine and community health
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    • v.42 no.3
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    • pp.119-131
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    • 2017
  • Objectives: The purpose of this study was to compare the diabetic management indicators between agriculture, forestry, and fishery workers (AFF) and other occupational adults (non-AFF) in community-dwelling diabetes. Methods: The study population consisted of 22,127 diabetic population ${\geq}19years$ who participated in the 2015 Community Health Survey. Chi-square test and logistic regression analysis was used to compare the diabetic management indicators between AFF and non-AFF. Socioeconomic characteristics such as age, gender, education level, monthly household income, National Basic Livelihood Security status, and marital status was sequentially adjusted. Results: Among total diabetic population, 3,712 people (16.8%) was AFF and 18,415 people (83.2%) was non-AFF. The fully-adjusted odds ratio [OR] (95% confidence interval [CI]) of current non-medical treatment (0.72, 0.66-0.79), measurement of hemoglobin A1c (0.61, 0.55-0.67), screening for diabetic retinopathy (0.76, 0.70-0.83), screening for diabetic nephropathy (0.75, 0.70-0.81), non-alcoholic or moderate drinking (0.70, 0.64-0.78), nutrition label reading (0.83, 0.71-0.98), low salt preference (0.85, 0.78-0.93), dental examination (0.60, 0.54-0.66), scaling experience (0.84, 0.77-0.93), regular toothbrushing (0.66, 0.58-0.76), and diabetes management education (0.84, 0.77-0.92) was significantly lower in AFF compared to non-AFF. In contrast, the fully-adjusted OR (95% CI) of AFF's low stress level (1.39, 1.26-1.52) and adequate sleep duration (1.22, 1.13-1.32) was significantly higher than non-AFF, which are better indicators of diabetic management in AFF. Conclusions: Overall, the level of diabetes management of AFF was not as good as that of non-AFF. In order to improve the level of diabetes management of AFF, a delicate diabetes intervention strategy considering the occupational characteristics of AFF will be needed.

A new diagnostic method for diabetic neuropathy using $TcpO_2$ ($TcpO_2$ 이용한 당뇨병성 신경병증 환자의 조기진단)

  • Hong, Hyun-Ki;Kim, Sung-Woo;Nam, Ki-Chang;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.44 no.3
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    • pp.1-8
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    • 2007
  • PDiabetic neuropathy is one of the most common diabetes related complications including diabetic nephropathy and retinopahty. In clinical practices, nerve conduction velocity (NCV) has been used as a standard method for diagnosing diabetic neuropathy. However, it applies maximum current of 100mA to nerves causing stress and pain to patients. In this study, as a non-invasive method, $TcpO_2$ was utilized to investigate the difference and relationship between $TcpO_2$ and $SpO_2$ of normal and diabetic neuropathy subjects. In addition, a new method of diagnosing diabetic neuropathy using $TcpO_2$ is suggested. 50 normal subjects and 50 diabetic patients with neuropathy diagnosed by NCV participated in this study. Parameters used in this study were $TcpO_2$, $TcpCO_2$, and $SpO_2$. As a result of the $TcpO_2$ measurements, statistical significances were found from $TcpO_2$ of hands and feet from normal and patients group(p<0.01). $SpO_2$ measured from index finger of normal and patient groups showed no statistical significance(p>0.05). On the other hand, $SpO_2$ measured from great toes of normal and patient groups showed statistical significance(p<0.01). Correlation coefficient between $SpO_2$ of finger and $TcpO_2$ of hand was 0.400 (p<0.01) and $SpO_2$ of toe and $TcpO_2$ of foot was 0.471(p<0.01). Both correlation values were statistically significant. Sensitivities and specificities of the $TcpO_2$ method were found to be 66 % and 92 %, respectively. If the suggested $TcpO_2$ method is used periodically, prevention and early diagnosis of diabetic neuropathy would be possible.

Bilateral Inguinal Hernias Detected by Peritoneal Scintigraphy during the Evaluation of Scrotal Swelling in a Patient on Continuous Ambulatory Peritoneal Dialysis (지속적 복막 투석 환자의 음낭부종 검사시 복막 신티그라피에 의해 발견된 양측성 서혜부 탈장)

  • Lim, Seok-Tae;Sohn, Myung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.81-82
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    • 2001
  • A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialysate mixed with 111 MBq of Tc-99m sulfur colloid were administered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%.$^{1)}$ Inguinal hernias were frequently manifested as scrotal swelling. Leakages of dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clinical findings of inguinal hernia.$^{1,2)}$ In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.

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