Influence of obesity on kidney disease in patients with diabetes mellitus type 2
- Authors: Savel'eva SA1, Kryachkova AA1, Zheleznyakova AV1, Vikulova OK1, Kutyrina IM1, Shestakova MV1
-
Affiliations:
- Issue: No 6 (2010)
- Pages: 48-51
- Section: Articles
- URL: https://journals.eco-vector.com/2075-3594/article/view/245943
- ID: 245943
Cite item
Full Text
Abstract
Aim. Evaluation of the association of obesity and renal affection in diabetes mellitus (DM) type 2.
Methods. 106 patients (41 male, 65 female, mean age 60,0± 7,0 years) with DM were included into the study. Exclusion criteria were DM duration <5 years, glomerular filtration rate (GFR) < 60 ml/min/m2, proteinuria >2 g/day. In all patients body mass index (BMI) was determined. Serum creatinine level, uricaemia, total cholesterol, LDL-, VLDL, HDL- cholesterol and triglyceride serum concentrations, as well as adiponectin and leptin plasma concentrations were evaluated. Kidney disease was diagnosed according to GFR and albuminuria parameters. All patients were divided into 2 groups - BMI<30 kg/m2 and BMI≥30 kg/m2). In 65 patients with DM type 2 association of Pro12Аlа allele gene of PPAR-γ-receptor (PPAR-γ) with risk of development of diabetic nephropathy was assessed. 26 patients with diabetic nephropathy had proteinuria or microalbuminuria, 39 patients with DM type 2 duration >10 years had no microalbuminuria/proteinuria and GFR> 60 ml/min/m2.
Results. In DM type 2 patients frequency of microalbuminuria and proteinuria increased with increasing of obesity severity (р<0,05). In DM type 2 patients with BMI ≥30 kg/m2 blood pressure levels, uricemia were higher and more oftener HDL-cholesterol levels diminishing was revealed. Leptinemia serum concentration increased in association with BMI. Hyperleptinemia was revealed in all patients with proteinuria. 89% DM type 2 patients had decreased concentrations of adiponcetin. Serum adiponectin level was lower in patients with microalbuminuria and increased in patients with proteinuria. Associations of Pro12Ala polymorphism of PPAR-γ gene with risk of diabetic nephropathy development was not found.
Conclusion. In DM type 2 patients obesity is on of the cofactors of kidney disease progression.
Methods. 106 patients (41 male, 65 female, mean age 60,0± 7,0 years) with DM were included into the study. Exclusion criteria were DM duration <5 years, glomerular filtration rate (GFR) < 60 ml/min/m2, proteinuria >2 g/day. In all patients body mass index (BMI) was determined. Serum creatinine level, uricaemia, total cholesterol, LDL-, VLDL, HDL- cholesterol and triglyceride serum concentrations, as well as adiponectin and leptin plasma concentrations were evaluated. Kidney disease was diagnosed according to GFR and albuminuria parameters. All patients were divided into 2 groups - BMI<30 kg/m2 and BMI≥30 kg/m2). In 65 patients with DM type 2 association of Pro12Аlа allele gene of PPAR-γ-receptor (PPAR-γ) with risk of development of diabetic nephropathy was assessed. 26 patients with diabetic nephropathy had proteinuria or microalbuminuria, 39 patients with DM type 2 duration >10 years had no microalbuminuria/proteinuria and GFR> 60 ml/min/m2.
Results. In DM type 2 patients frequency of microalbuminuria and proteinuria increased with increasing of obesity severity (р<0,05). In DM type 2 patients with BMI ≥30 kg/m2 blood pressure levels, uricemia were higher and more oftener HDL-cholesterol levels diminishing was revealed. Leptinemia serum concentration increased in association with BMI. Hyperleptinemia was revealed in all patients with proteinuria. 89% DM type 2 patients had decreased concentrations of adiponcetin. Serum adiponectin level was lower in patients with microalbuminuria and increased in patients with proteinuria. Associations of Pro12Ala polymorphism of PPAR-γ gene with risk of diabetic nephropathy development was not found.
Conclusion. In DM type 2 patients obesity is on of the cofactors of kidney disease progression.
About the authors
S A Savel'eva
A A Kryachkova
A V Zheleznyakova
O K Vikulova
I M Kutyrina
M V Shestakova
References
- Кутырина И.М., Федорова Е.Ю. Вклад ожирения в поражение почек при сахарном диабете (экспериментальное исследование). Сахарный диабет 2008; 2: 8-10.
- Шестакова М.В., Дедов И.И. Сахарный диабет и хроническая болезнь почек. М: Медицинское информационное агентство; 2009.
- Masaomi N., Yuko I., Nobuteru U. In a type 2 diabetic nephropathy rat model, the improvement of obesity by a low calorie diet reduces oxidative/carbonyl stress and prevents diabetic nephropathy. Nephrol. Dial. Transplant. 2005; 20: 2661-2669
- Kamari Y., Avni I., Grossman E. Adiponectin - a novel anti-atherogenic factor in the metabolic syndrome: mechanisms of action and therapeutic potential. Vascular Disease Prevention <http://www.ingentaconnect.com/content/ben/vdp;jsessionid=dywig7cpmi0t.alice> 2005; 2: 107-114.
- Tomic М., Poljicanin Т., Pavlic-Renar I. Obesity- a risk factor for microvascular and neuropathic complications in diabetes? Diabetologia Croatica 2003; 2(32): 73-78.
- Boer I., Sibley S., Kestenbaum B. at al. Central obesity, incident microalbuminuria, and change in creatinine clearance in the epidemiology of diabetes interventions and complications study. J. Am. Soc. Nephrol. 2007; 18: 235-243.
- Pinto-Sietsma S., Janssen W., Hillege H. et al. Urinary albumin excretion is associated with renal functional abnormalities in a nondiabetic population. J. Am. Soc. Nephrol. 2000; 11:1882-1888
- Wolf G (ed). Obesity and the Kidney. Contributions to Nephrology. Basel, Kager; 2006.
- Ballermann B. A role for leptin in glomerulosclerosis? Kidney International 1999; 56: 1154-1155.
- Tomaszewski М., Charchar F., Maric C. et al. Glomerular hyperfiltration: A new marker of metabolic risk. Kidney International 2007, 71: 816-821
- Демидова Т.Ю., Селиванова А.В., Аметов А.С. Роль жировой ткани в развитии метаболических нарушений у больных сахарным диабетом 2-типа в сочетании с ожирением. Тер. архив 2006; 11: 64-69.
- Tschritter O., Fritsche A., Thamer C <http://www.ncbi.nlm.nih.gov/pubmed?term=%22Thamer%20C%22%5BAuthor%5D>. Plasma adiponectin concentrations predict insulin sensitivity of both glucose and lipid metabolism. Diabetes <javascript:AL_get(this,%20'jour',%20'Diabetes.');> 2003; 52 (2): 239-43.
- Stejskal D., Ruzicka V., Adamovska S. Adiponectin concentrations as a criterion of metabolic controlin persons with type 2 diabetes mellitus? Biomed. Papers 2003; 147(2): 167-172.
- Sharma K., Ramachandra S., Gang.Q. Adiponectin regulates albuminuria and podocyte function in mice. J. Clin. Invest. 2008; 118(5): 1645-1656.
Supplementary files
