Objective:To investigate the relationship between age of onset of type 2 diabetes mellitus and renal prognosis in diabetic nephropathy (DN) patients.Methods:A total of 76 diabetic nephropathy patients diagnosed by kidney biopsy in the Second Hospital of Lanzhou University from January 2017 to January 2019 were included. Type 2 diabetes was divided into early onset group (26 cases, onset age <40 years old) and late onset group (50 cases, onset age ≥40 years old) according to the onset age of type 2 diabetes. Clinical parameters, pathological characteristics of renal tissue and correlation between clinical parameters and renal pathology of the two groups were analyzed when DN was diagnosed. After 5 years of follow-up, Log-rank test and Cox univariate regression analysis were used to determine the renal prognosis of the two groups.Results:Compared with the late onset group, the onset age of diabetes and the time of renal biopsy were earlier in the early onset group, and the duration of diabetes was longer when kidney injury occurred in the early onset group (all P<0.05). Compared with the late group, the glomerular basement membrane (GBM) was thicker in the early group ( P=0.035). GBM thickness was negatively correlated with age at onset of type 2 diabetes ( r=-0.359, P=0.003), positively correlated with duration of diabetes ( r=0.300, P=0.023), but not with age at renal biopsy ( r=-0.205, P=0.144). During follow-up, 3 and 5 patients died in the early-onset and late-onset groups, and 11 and 28 patients progressed to end-stage renal disease (ESRD), respectively. The 5-year cumulative renal survival rate in the two groups was 36.4% and 20.7%, respectively. Log-rank test showed similar renal outcomes in the two groups ( P=0.340). The risk of progression to ESRD was similar between the two groups ( HR=1.045; 95% CI: 0.977 to 1.117, P=0.199), and the estimated annual decline in estimated glomerular filtration rate (eGFR) was similar between the two groups [(26.40±21.25)% vs (33.32±25.53)%, P=0.248]. Conclusions:During 5-year follow-up, the risk of progression to ESRD was similar in the early-onset and late-onset groups. The early-onset group did not show a faster decline in renal function and a worse renal prognosis.

Objective:To investigate the relationship between age of onset of type 2 diabetes mellitus and renal prognosis in diabetic nephropathy (DN) patients.Methods:A total of 76 diabetic nephropathy patients diagnosed by kidney biopsy in the Second Hospital of Lanzhou University from January 2017 to January 2019 were included. Type 2 diabetes was divided into early onset group (26 cases, onset age <40 years old) and late onset group (50 cases, onset age ≥40 years old) according to the onset age of type 2 diabetes. Clinical parameters, pathological characteristics of renal tissue and correlation between clinical parameters and renal pathology of the two groups were analyzed when DN was diagnosed. After 5 years of follow-up, Log-rank test and Cox univariate regression analysis were used to determine the renal prognosis of the two groups.Results:Compared with the late onset group, the onset age of diabetes and the time of renal biopsy were earlier in the early onset group, and the duration of diabetes was longer when kidney injury occurred in the early onset group (all P<0.05). Compared with the late group, the glomerular basement membrane (GBM) was thicker in the early group ( P=0.035). GBM thickness was negatively correlated with age at onset of type 2 diabetes ( r=-0.359, P=0.003), positively correlated with duration of diabetes ( r=0.300, P=0.023), but not with age at renal biopsy ( r=-0.205, P=0.144). During follow-up, 3 and 5 patients died in the early-onset and late-onset groups, and 11 and 28 patients progressed to end-stage renal disease (ESRD), respectively. The 5-year cumulative renal survival rate in the two groups was 36.4% and 20.7%, respectively. Log-rank test showed similar renal outcomes in the two groups ( P=0.340). The risk of progression to ESRD was similar between the two groups ( HR=1.045; 95% CI: 0.977 to 1.117, P=0.199), and the estimated annual decline in estimated glomerular filtration rate (eGFR) was similar between the two groups [(26.40±21.25)% vs (33.32±25.53)%, P=0.248]. Conclusions:During 5-year follow-up, the risk of progression to ESRD was similar in the early-onset and late-onset groups. The early-onset group did not show a faster decline in renal function and a worse renal prognosis.

Objective To discuss clinical or laboratory indicators that can predict diabetic kidney disease(DKD)and diabetes patients with non-diabetic kidney disease(NDKD).Methods A total of 130 cases type 2 diabetes mellitus with renal injury confirmed by renal biopsy from January 2017 to December 2021 in the Department of Nephrology,the Second Hospital of Lanzhou University were retrospectively analyzed.According to the pathological type of kidney,the patients were divided into three groups:DKD group(77 cases),NDKD group(34 cases),and DKD+NDKD group(19 cases).Clinical or laboratory indicators among three groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of DKD and NDKD,receiver operating characteristic(ROC)curve was used to predict sensitivity and specificity of DKD and NDKD.Results Primary glomerulonephritis was the main type of renal injury in type 2 diabetes mellitus patients with NDKD,of which IgA nephropathy was the most common pathological type,followed by membranous nephropathy and minimal change glomerulonephritis.Single factor analysis of variance showed that compared with DKD group,NDKD group had a shorter history of diabetes,and a lower proportion of diabetes retinopathy and impaired cardiac diastolic function.Multivariate Logistic regression analysis found that the history of diabetes and diabetes retinopathy were risk factors for predicting DKD and NDKD.ROC curve analysis showed that the history of diabetes＜6.5 years and no diabetes retinopathy could be used as clinical indicators to better predict NDKD.Conclusion NDKD is a common type of type 2 diabetes mellitus with renal injury.The short history of diabetes and no diabetes retinopathy suggest that it may be NDKD,and renal biopsy should be performed in time to make a clear diagnosis.

Objective To investigate the expression and clinical significance of serum microRNA (miRNA) expression profiling in the occurrence and progression of diabetic nephropathy.Methods The miRNA expression profiling was detected by miRNA TaqMan Low Density Array chip from 10 patient with diabetic nephropathy,10 diabetes patients with normoalbuminuria and 10 health control.Real-time quantitative PCR was applied to verify the result of miRNA array in serum samples of 66 patients with diabetic nephropathy (36 patients with microalbuminuria,30 patients with macroalbuminuria),40 diabetes patients with normoalbuminuria and 40 health control.And the relationship of differetial expression with clinical features was analyzed.Results miR-150-5p,miR-155-5p,miR-30e-5p and miR-3196 being validated by real-time quantitative PCR differentially expressed in 3 groups of serum samples from the diabetes patients with microalbuminuria (n=36),with normoalbuminuria (n=40) and health control (n=40) (P ＜ 0.05).Serum miR-150-5p (P=0.005) and miR-155-5p (P=0.006) changed significantly between diabetes patients with microalbuminuria (n=36) and with macroalbuminuria (n=30).Compared with the diabetes patients with microalbuminuria,serum miR-150-5p and miR-155-5p increased by 2.3 and 1.5 times in macroalbuminuria group,respectively.Estimated glomerular filtration rate and urinary albumin excretion rate significantly correlated with serum miR-150-5p and miR-155-5p level.Conclusions miR-150-5p and miR-155-5p may be involved in the process of pathological mechanisms of diabetic nephropathy.Serum miR-150-5p and miR-155-5p may be regarded as potential biomarkers to diagnosis the occurrence and development of diabetic nephropathy.