Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
International Journal of Diabetes in Developing Countries
Erschienen in: International Journal of Diabetes in Developing Countries 2/2019

15.02.2019 | Original Article

Clinical and biochemical characteristics and the association of angiotensin type 1 receptor with normoalbuminuric chronic kidney disease among South Indian type 2 diabetes population

verfasst von: Vijay Viswanathan, Ezhilarasi Krishnamoorthy, Satyavani Kumpatla, Bliss Lunghar, Anju Soni, Anitha Rani

Erschienen in: International Journal of Diabetes in Developing Countries | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

The aim of the study was to determine the clinical and biochemical characteristics especially cystatin C and the association of angiotensin type I receptor (AT1R) gene polymorphism with normoalbuminuric chronic kidney disease (NACKD) among South Indian type 2 diabetes (T2DM) population.

Material and methods

The study comprised of 308 (M:F 190:118) subjects with T2DM categorized into three groups. Group I: T2DM patients without albuminuria (NA) and estimated glomerular filtration rate (eGFR) > 90 ml/min/1.73m2 (n = 110); group II: T2DM patients with albuminuric chronic kidney disease (CKD) with eGFR < 60 ml/min/1.73m2 (n = 98); and group III: T2DM patients with normoalbuminuric CKD (NACKD) and eGFR < 60 ml/min/1.73m2 (n = 100). The eGFR was estimated using the Modification of Diet in Renal Disease (MDRD) formula. Cystatin C was measured by particle-enhanced immunoturbidimetric assay. AT1R gene polymorphism was analyzed using the PCR-RFLP method.

Results

The biochemical parameters urea, creatinine, post prandial glucose, HbA1c, triglycerides, cystatin C levels, erythrocyte sedimentation rate (ESR), and diastolic blood pressure were lower and the levels of calcium were higher in normoalbuminuric CKD subjects as compared to albuminuric CKD subjects. The AT1R genotypic distribution of AA, AC, and CC was 80.2%, 19.8%, and 0% in NACKD, and 95.1%, 4.9%, and 0% in CKD subjects. The distribution of allelic frequencies of A and C allele in NACKD was 90.1% and 9.9%, and in CKD, it was 97.6% and 2.4% respectively. The relative risk of AC (p = 0.08) genotype and C (p = 0.01) allele in NACKD was 4 times higher as compared to CKD.

Conclusion

The present study highlighted that the clinical and biochemical parameters showed significant differences especially cystatin C whose levels increased in normoalbuminuric CKD subjects as compared to normoalbuminuric subjects. Significant association of AGTR1 A1166C polymorphism was observed in normoalbuminuric CKD subjects as compared to CKD subjects with T2DM.
Literatur
1.
Afghahi H, Cederholm J, Eliasson B, Zethelius B, Gudbjornsdottir S, Hadimeri H, et al. Risk factors for the development of albuminuria and renal impairment in type 2 diabetes—the Swedish National Diabetes Register (NDR). Nephrol Dial Transplant. 2011;26:1236–43.CrossRefPubMed
2.
Ahluwalia TS, Ahuja M, Rai TS, Kohli HS, Bhansali A, Sud K, et al. ACE variants interact with the RAS pathway to confer risk and protection against type 2 diabetic nephropathy. DNA Cell Biol. 2009;28:141–50.CrossRefPubMed
3.
Boronat M, Garcia-Canton C, Quevedo V, Lorenzo DL, Lopez-Rios L, Batista F, et al. Non-albuminuric renal disease among subjects with advanced stages of chronic kidney failure related to type 2 diabetes mellitus. Ren Fail. 2014;36(2):166–70.CrossRefPubMed
4.
Bostom AG, Dworkin LD. Cystatin C measurement: improved detection of mild decrements in glomerular filtration rate verses creatinine-based estimates? Am J Kidney Dis. 2000;36(1):205–7.CrossRefPubMed
5.
Buraczynska M, Ksiazek P, Drop A, Zaluska W, Spasiewicz D, Ksiazek A. Genetic polymorphisms of the renin–angiotensin system in end-stage renal disease. Nephrol Dial Transplant. 2006;21:979–83.CrossRefPubMed
6.
Chang HR, Cheng CH, Shu KH, Chen CH, Lian JD, Wu MY. Study of the polymorphism of angiotensinogen, angiotensin-converting enzyme and angiotensin receptor in type II diabetes with end-stage renal disease in Taiwan. J Chin Med Assoc. 2003;66(1):51–6.PubMed
7.
Dagenais GR, Pogue J, Fox K, Simoons ML, Yusuf S. Angiotensin-converting-enzyme inhibitors in stable vascular disease without left ventricular systolic dysfunction or heart failure: a combined analysis of three trials. Lancet. 2006;368:581–8.CrossRefPubMed
8.
Dayanidhi S, Ramadevi K, Periyandavar I. Serum cystatin C and microalbumin in the detection of early nephropathy in type 2 diabetic patients. Int J Pharm Bio Sci. 2015;6:1208–14.
9.
Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. Am J Kidney Dis. 2002;40:221–6.CrossRefPubMed
10.
Fioretto P, Mauer M, Brocco E, Velussi M, Frigato F, Muollo B, et al. Patterns of renal injury in NIDDM patients with microalbuminuria. Diabetologia. 1996;39:1569–76.CrossRefPubMed
11.
Fradin S, Goulet-Salmon B, Chantepie M, Grandhomme F, Morello R, et al. Relationship between polymorphisms in the renin–angiotensin system and nephropathy in type 2 diabetic patients. Diabetes Metab. 2002;28(1):27–32.PubMed
12.
Garg AX, Kiberd BA, Clark WF, Haynes RB, Clase CM. Albuminuria and renal insufficiency prevalence guides population screening: results from the NHANES III. Kidney Int. 2002;61:2165–75.CrossRefPubMed
13.
Jacobsen P, Tarnow L, Carstensen B, Hovind P, Poirier O, Parving HH. Genetic variation in the renin– angiotensin system and progression of diabetic nephropathy. J Am Soc Nephrol. 2003;14:2843–50.CrossRefPubMed
14.
JAMA Article : Early Release Article, posted May 14, 2003: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
15.
Jeon YK, Kim MR, Huh JE, Mok JY, Song SH, Kim SS, et al. Cystatin C as an early biomarker of nephropathy in patients with type 2 diabetes. J Korean Med Sci. 2011;26:258–63.CrossRefPubMedPubMedCentral
16.
17.
Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130:461–70.CrossRefPubMed
18.
Lim LM, Kuo HT, Kuo MC, Chiu YW, Lee JJ, Hwang SJ, et al. Low serum calcium is associated with poor renal outcomes in chronic kidney disease stages 3-4 patients. BMC Nephrol. 2014;15:183.CrossRefPubMedPubMedCentral
19.
Maniatis T, Fritsch EF, Sambrook J, et al. Molecular cloning: a laboratory manual. Cold Spring Harbor, New York: Cold Spring Harbor Laboratory; 1982. p. 149–51.
20.
Mauro B, Cesar G, Virginia Q, Lorenzo DL, Laura L, Fatima B, et al. Non-albuminuric renal disease among subjects with advanced stages of chronic kidney failure related to type 2 diabetes mellitus. Ren Fail. 2013:1525–6049.
21.
Modi KS, Rao VK. Atheroembolic renal disease. J Am Soc Nephrol. 2001;12(8):1781–7.PubMed
22.
Mussap M, Dalla Vestra M, Fioretto P, Saller A, Varagnolo M, Nosadini R, et al. Cystatin C is a more sensitive marker than creatinine for the estimation of GFR in type 2 diabetic patients. Kidney Int. 2002;61:1453–61.CrossRefPubMed
23.
Osawa N, Koya D, Araki S, Uzu T, Tsunoda T, Kashiwagi A, et al. Combinational effect of genes for the renin–angiotensin system in conferring susceptibility to diabetic nephropathy. J Hum Genet. 2007;52:143–51.CrossRefPubMed
24.
Parving H-H, Mauer M, Ritz E. Diabetic nephropathy. In: Brenner BM, editor. Brenner and Rector’s the kidney. 7th ed. Philadelphia: WB Saunders; 2004. p. 1777–818.
25.
Prasad P, Tiwari AK, Prasanna KM, Ammini AC, Gupta A. Chronic renal insufficiency among Asian Indians with type 2 diabetes: I. Role of RAAS gene polymorphisms. BMC Med Genet. 2006;7:1–9.CrossRef
26.
Price CP, Finney H. Developments in the assessment of glomerular filtration rate. Clin Chem Acta. 2000;297(1–2):55–66.CrossRef
27.
Pucci L, Triscornia S, Lucchesi D, Fotino C, Pellegrini G, Pardini E, et al. Cystatin C and estimates of renal function: searching for a better measure of kidney function in diabetic patients. Clin Chem. 2007;53:480–8.CrossRefPubMed
28.
Remuzzi G, Ruggenenti P. Overview of randomised trials of ACE inhibitors. Lancet. 2006;368:555–6.CrossRefPubMed
29.
Retnakaran R, Cull CA, Thorne KI, Adler AI, Holman RR, for the UKPDS Study Group. Risk factors for renal dysfunction in type 2 diabetes. U.K. Prospective Diabetes Study 74. Diabetes. 2006;55:1832–9.CrossRefPubMed
30.
Rigalleau V, Beauvieux MC, Le Moigne F, Lasseur C, Chauveau P, Raffaitin C, et al. Cystatin C improves the diagnosis and stratification of chronic kidney disease, and the estimation of glomerular filtration rate in diabetes. Diabetes Metab. 2008;34:482–9.CrossRefPubMed
31.
Rossing P, Hougaard P, Borch-Johnsen K, Parving H-H. Predictors of mortality in insulin dependent diabetes: 10 year follow up study. BMJ. 1996;313:779–84.CrossRefPubMedPubMedCentral
32.
Ruggenenti P, Bettinaglio P, Pinares F, Remuzzi G. Angiotensin converting enzyme insertion deletion polymorphism and renoprotection in diabetic and nondiabetic nephropathies. Clin J Am Soc Nephrol. 2008;3(5):511–25.CrossRef
33.
Satyavani K, Hemalatha K, Shabana T, Viswanathan V. The costs of treating long term diabetic complications in a developing country: a study from India. J Assoc Physicians India. 2013;61:102–9.
34.
Smith HW. The kidney: structure and function in health and disease. New York: Oxford University Press; 1951. p. 63–6.
35.
Tomino Y, Makita Y, Shike T, Gohda T, Haneda M, Kikkawa R. Relationship between polymorphism in the angiotensinogen, angiotensin-converting enzyme or angiotensin II receptor and renal progression in Japanese NIDDM patients. Nephron. 1999;82:139–44.CrossRefPubMed
36.
Rinnno H, Iijima T, Takeda Y, Shimizu A, Kobata M, et al. Serum cystatin c levels in hypertensive type 2 diabetic nephropathy patients after treatment with angiotensin converting enzyme (ACE) inhibitor temocapril. Acta Nephrol. 2002;16:62–5.
37.
Young RP, Chan JC, Critchley JA, Poon E, et al. Angiotensinogen T235 and ACE insertion/deletion polymorphisms associated with albuminuria in Chinese type 2 diabetic patients. Diabetes Care. 1998;21:431–437
Metadaten
Titel
Clinical and biochemical characteristics and the association of angiotensin type 1 receptor with normoalbuminuric chronic kidney disease among South Indian type 2 diabetes population
verfasst von
Vijay Viswanathan
Ezhilarasi Krishnamoorthy
Satyavani Kumpatla
Bliss Lunghar
Anju Soni
Anitha Rani
Publikationsdatum
15.02.2019
Verlag
Springer India
Erschienen in
International Journal of Diabetes in Developing Countries / Ausgabe 2/2019
Print ISSN: 0973-3930
Elektronische ISSN: 1998-3832
DOI
https://doi.org/10.1007/s13410-019-00719-0

Weitere Artikel der Ausgabe 2/2019

International Journal of Diabetes in Developing Countries 2/2019 Zur Ausgabe

Original Article

Prevalence of thyroid disorders is not different in type 2 diabetes mellitus compared to nondiabetics in South India

Original Article

Prevalence of diabetic micro vascular complications at a tertiary care unit of Karachi, Pakistan

Original Article

Postprandial lipemia and its relation to TCF7L2 gene polymorphisms in normoglycemic first-degree relatives of type 2 diabetes patients

Original Article

LncRNA Gm4419 promotes the development of cardiac diseases in type 2 diabetic patients with diabetic nephropathy

Original Article

Dietary zinc reduces endoplasmic reticulum stress and autophagy to protect against diabetic renal damage in streptozotocin-induced diabetic rats

Letter to the Editor

Maternal anxiety and competency of mothers of children with type 1 diabetes