Effect of lipoic acid on urinary microalbumin and inflammation in patients with diabetic nephropathy at different stages

doi:10.3877/cma.j.issn.1674-0785.2019.04.001

Abstract

Abstract:

Objective

To investigate the effect of lipoic acid on urinary microalbumin and inflammation in patients with diabetic nephropathy at different stages.

Methods

Ninety patients with type 2 diabetes who were hospitalized at the Department of Endocrinology, Meizhou People's Hospital from July 2015 to December 2017 were selected, and they were divided into three groups according to 24-hour urinary albumin excretion rate (UAER): normal albuminuria group (NA group, UAER<30 mg/24 h), microalbuminuria group (MA group, 30 mg/24 h≤UAER<300 mg/24 h), and clinical nephropathy group (CN group, UAER≥300 mg/24 h). At the same time, we randomly selected 30 patients who underwent physical examination as a normal control group (NC group). Then, the three groups of diabetes patients were randomly and equally divided into an observation group and a control group using a random number table. The control group was given conventional treatment. The observation group was given 0.45 g lipoic acid for injection plus 0.9% sodium chloride injection 250 mL by slow intravenous infusion, once a day for 2 weeks. The changes of UAER, serum creatinine (SCr), blood glucose, hs-CRP, and TNF-α levels were observed.

Results

The levels of serum hs-CRP and TNF-α in the three groups of patients with type 2 diabetic nephropathy were significantly higher than those in the NC group [(5.98±1.54) mg/L, (6.49±1.84) mg/L, (7.02±1.75) mg/L vs (2.95±0.86) mg/L, F=15.63, P<0.01; (17.19±5.05) ng/L, (19.61±5.42) ng/L, (20.25±6.23) ng/L vs (10.24±3.16) ng/L, F=25.22, P<0.01]; however, there was no significant difference among the three groups of patients with type 2 diabetic nephropathy. The levels of hs-CRP, TNF-α, SCr, and UAER were decreased significantly after lipoic acid treatment in the observation groups than in the control groups [(5.01±0.93) mg/L vs (3.89±0.72) mg/L, (5.51±1.23) mg/L vs (4.25±0.88) mg/L, (6.15±1.32) mg/L vs (4.78±1.01) mg/L, t=3.689, 3.227, 3.192, P<0.05; (15.59±4.19) ng/L vs (12.04±3.45) ng/L, (18.02±4.42) ng/L vs (14.43±4.22) ng/L, (18.67±4.88) ng/L vs (15.09±4.47) ng/L, t=2.526, 2.275, 2.095, P<0.05; (83.5±9.4) μmol/L vs (67.3±6.2) μmol/L, (85.6±16.0) μmol/L vs (61.3±16.7) μmol/L, (98.5±20.4) μmol/L vs (69.4±16.8) μmol/L, t=5.572, 4.069, 4.265, P<0.05; (16.5±7.4) mg/24 h vs (13.3±6.2) mg/24 h, (145.6±66.0) mg/24 h vs (106.3±56.7) mg/24 h, (805.5±166.4) mg/24 h vs (612.3±110.8) mg/24 h, t=5.597, 2.051, 3.742, P<0.05].

Conclusion

The inflammatory reaction exists in type 2 diabetic nephropathy patients. Lipoic acid can protect the kidney by improving the inflammatory state of type 2 diabetic nephropathy, reducing urinary microalbumin excretion, and lowering serum creatinine levels.

Key words: Lipoic acid, Diabetic nephropathy, Inflammatory factors, Hypersensitive C-reactive protein, Tumor necrosis factor alpha

Feng Shi, Yumei Wu, Huanghui Zeng, Yongxin Wu, Hongmei Wang. Effect of lipoic acid on urinary microalbumin and inflammation in patients with diabetic nephropathy at different stages[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(04): 241-245.

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References 15

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组别	例数	男/女	年龄（岁，±s）	BMI（kg/m²，±s）	病程（年，±s）	HbA1c（%，±s）	SBP（mmHg，±s）	DBP（mmHg，±s）	TG（mmol/L，±s）	TC（mmol/L，±s）	LDL-C（mmol/L，±s）
NA组	30	16/14	51.7±9.4	22.5±1.8	5.1±1.4	8.2±1.1	148.2±15.2	88.2±9.3	1.5±0.8	5.2±1.2	2.9±0.9
MA组	30	17/13	52.6±9.2	21.7±1.6	7.9±1.5^a	8.1±1.1	150.2±16.1	90.2±9.7	1.6±0.8	5.1±1.1	3.1±1.0
CN组	30	15/15	53.7±10.6	22.3±1.6	9.1±1.6^bc	8.2±1.2	152.2±15.3	91.3±9.2	1.6±0.9	5.3±1.2	3.1±0.9
统计值	?	χ²=0.267	F=1.085	F=0.432	F=12.682	F=0.269	F=0.312	F=0.225	F=0.287	F=0.487	F=0.978
P值	?	0.875	0.242	0.549	<0.001	0.689	0.606	0.722	0.701	0.511	0.304

组别	例数	男/女	年龄（岁，±s）	BMI（kg/m²，±s）	病程（年，±s）	HbA1c（%，±s）	SBP（mmHg，±s）	DBP（mmHg，±s）	TG（mmol/L，±s）	TC（mmol/L，±s）	LDL-C（mmol/L，±s）
NA组	30	16/14	51.7±9.4	22.5±1.8	5.1±1.4	8.2±1.1	148.2±15.2	88.2±9.3	1.5±0.8	5.2±1.2	2.9±0.9
MA组	30	17/13	52.6±9.2	21.7±1.6	7.9±1.5^a	8.1±1.1	150.2±16.1	90.2±9.7	1.6±0.8	5.1±1.1	3.1±1.0
CN组	30	15/15	53.7±10.6	22.3±1.6	9.1±1.6^bc	8.2±1.2	152.2±15.3	91.3±9.2	1.6±0.9	5.3±1.2	3.1±0.9
统计值	?	χ²=0.267	F=1.085	F=0.432	F=12.682	F=0.269	F=0.312	F=0.225	F=0.287	F=0.487	F=0.978
P值	?	0.875	0.242	0.549	<0.001	0.689	0.606	0.722	0.701	0.511	0.304

组别	例数	TNF-α（ng/L）	hs-CRP（mg/L）
NC组	30	10.24±3.16	2.95±0.86
NA组	30	17.19±5.05^a	5.98±1.54^a
MA组	30	19.61±5.42^b	6.49±1.84^b
CN组	30	20.25±6.23^c	7.02±1.75^c
F值	?	15.63	25.22
P值	?	0.001	<0.001

组别	例数	TNF-α（ng/L）	hs-CRP（mg/L）
NC组	30	10.24±3.16	2.95±0.86
NA组	30	17.19±5.05^a	5.98±1.54^a
MA组	30	19.61±5.42^b	6.49±1.84^b
CN组	30	20.25±6.23^c	7.02±1.75^c
F值	?	15.63	25.22
P值	?	0.001	<0.001

组别	例数	FPG（mmol/L）	PBG（mmol/L）	SCr（μmol/L）	UAER（mg/24 h）	hs-CRP（mg/L）	TNF-α（ng/L）
NA组对照组	15	6.4±1.5	9.0±2.1	83.5±9.4	16.5±7.4	5.01±0.93	15.59±4.19
NA组观察组	15	6.2±1.7	9.1±1.8	67.3±6.2	13.3±6.2	3.89±0.72	12.04±3.45
t值	?	0.342	0.036	5.572	5.597	3.689	2.526
P值	?	0.785	0.951	<0.001	<0.001	0.001	0.019
MA组对照组	15	6.5±1.6	9.2±2.0	85.6±16.0	145.6±66.0	5.51±1.23	18.02±4.42
MA组观察组	15	6.4±1.7	9.1±1.9	61.3±16.7	106.3±56.7	4.25±0.88	14.43±4.22
t值	?	0.166	0.140	4.069	2.051	3.227	2.275
P值	?	0.865	0.876	<0.001	0.049	0.003	0.034
CN组对照组	15	6.3±1.6	9.2±2.1	98.5±20.4	805.5±166.4	6.15±1.32	18.67±4.88
CN组观察组	15	6.3±1.5	9.0±1.9	69.4±16.8	612.3±110.8	4.78±1.01	15.09±4.47
t值	?	0.002	0.272	4.265	3.742	3.192	2.095
P值	?	0.997	0.821	<0.001	0.001	0.003	0.043

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