Renal protection of exenatide in patients with diabetic kidney disease in early stage
- Author:
Li-Jun ZHOU
1
Author Information
- Publication Type:Journal Article
- Keywords: Advanced glycosylation end product; CAMP/PKA signaling pathway; Diabetic kidney disease; Exenatide; Oxidative stress
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2019;40(6):967-972
- CountryChina
- Language:Chinese
- Abstract: Objective: To investigate the protective effect of exenatide on patients with diabetic kidney disease in early stage and its mechanism. Methods: From January 2015 to August 2018, a total of 80 patients with diabetic kidney disease in early stage in The First Affiliated Hospital of Soochow University were randomly divided into observation group and control group with 40 in each. Patients in control group were treated with olmesartan and metformin orally. Those in observation group were treated with exenatide subcutaneously on the basis of the same treatment in control group. Blood glucose, blood lipid, renal function, serum advanced glycosylation end products (AGEs), cyclic adenosine phosphate (cAMP), serum oxidative stress and peripheral blood mononuclear cells (PBMC) were compared before and after treatment. Results: After 24 weeks of treatment, the levels of FBG, HbAlc, MBG, SDBG, BGFR and MAG were significantly lower in observation group than in control group (P<0.05). The levels of TC, LDL-C and TG in observation group were also significantly lower than those in control group (P<0.05), while the level of HDL-C was significantly higher than that in control group (P<0.05). The systolic and diastolic blood pressure in observation group was not significantly different before and after treatment (P>0.05). However, the systolic and diastolic blood pressure in control group was significantly decreased after treatment (P<0.05). After 24 weeks of treatment, the levels of Scr, Umalb and ACR were significantly decreased (P<0.05) whereas eGFR was significantly increased (P<0.05) in observation group. The levels of serum AGEs, cAMP and MDA levels were also significantly decreased (P<0.05), while serum SOD and CAT levels were significantly increased (P<0.05). After 24 weeks of treatment, the levels of PKA and p-CREB protein in peripheral blood mononuclear cells of the observation group were significantly lower than those of control group (P<0.05), but the level of CREB protein was not significantly different from that of control group (P>0.05). Conclusion: Exenatide has a certain protective effect on diabetic kidney disease in early stage. It may be related to decreasing AGEs production, improving oxidative stress and regulating cAMP/PKA signaling pathway.
