Analysis Of Risk Factors Related To Diabetic Nephropathy And Potential Pharmacodynamic Substances Basis Of Huangkui Capsule In Treating Diabetic Nephropathy

Objective:Firstly,the clinical data of patients with type 2 diabetic nephropathy in Yichun area were retrospectively analyzed,and the related risk factors were discussed.Then,ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry technology combined with network pharmacology and molecular docking technology was used to explore the effective material basis of Huangkui capsule in treating diabetic nephropathy.Methods:The data of patients with type 2 diabetes mellitus from September 2019 to September 2021 in the Department of Endocrinology of Yichun People’s Hospital were selected and divided into simple type 2 diabetes mellitus group（T2DM group,100 cases）and diabetic nephropathy group（DN group,113 cases）.The general data and clinical indicators of the two groups were retrospectively analyzed.Spearman analysis was used to calculate the correlation with various indicators,multivariate Logistic regression analysis was used to analyze the relevant risk factors of DN patients,and ROC curve analysis was used to analyze the diagnostic value.The components absorbed into the blood in Huangkui capsule were comprehensively analyzed by mass spectrometry,and the target of absorbed components in the blood was predicted by TCMSP database.Gene Cards,Dis Ge NET and other databases were used to obtain the disease targets of DN,and GO enrichment analysis and KEGG pathway analysis were performed on the drug efficacy disease targets.With the help of autodock software,the molecular docking between the blood entering compound and the core target was carried out.The chemical components and blood components of Huangkui capsule were comprehensively analyzed by mass spectrometry,and the target of absorbed components in the blood was predicted by TCMSP database.Gene Cards,Dis Ge NET and other databases were used to obtain the disease targets of DN,and GO enrichment analysis and KEGG pathway analysis were performed on the drug efficacy disease targets.With the help of autodock software,the molecular docking between the blood entering compound and the core target was carried out.Results:1.Compared with T2DM group,SUA value of DN group was significantly higher（P<0.05）.The median values of age,course of disease,SBP,DBP,NLR,PLR,Scr,BUN,β₂MG,RBP,TG,VLDL-C and TSH in DN group were higher than those in T2DM group（P<0.01）.Spearman correlation analysis showed that age,course of disease,SBP,DBP,NLR,Scr,BUN,RBP,β₂MG,TG,VLDL-C and TSH were positively correlated with UACR.Multiple Logistic regression analysis showed that the course of disease,SBP,NLR,Scr,BUN,β₂MG and TSH were risk factors for diabetic nephropathy.ROC curve analysis showed that the best critical values of disease course,SBP,NLR,Scr,BUN,β₂MG and TSH as the predictive indexes of DN are 6.5,138.5,2.2582,69.5,5.05,2.35 and 2.2231respectively.2.A total of 22 main components of Huangkui capsule were identified in vitro,mainly flavonoids and organic acids,and 2 components in vivo.Through structural analysis,it was found that some components in Huangkui capsule existed in the form of quercetin glycoside conjugates after entering the blood.Therefore,it was deduced that the functional component of Huangkui capsule may be quercetin.The above compounds act on39 core targets,including IL6,TNF and other targets,which are related to inflammation,VEGFA and other targets are related to vascular endothelium,and NOS3 and other targets are related to oxidative stress.The results of molecular docking showed that the blood entering compound had good binding activity with the core target.Conclusion.Quercetin in Huangkui capsule exerts anti-inflammatory,anti apoptotic and antioxidant effects through TNF,toll like receptor,NF-kappa B and other signal pathways,so as to improve DN,which provides a experimental basis for the clinical application of Huangkui capsule in the treatment of DN.Conclusion:Gender,age,DBP,PLR,FPG,FPC-P,Hb Alc,GSP,RBP,BUA,TG,TC,HDL-C,VLDL-C and LDL-C levels may not be related to DN.Course of disease,SBP,NLR,Scr,BUN,β₂MG,TSHDN are important risk factors,which can be used to assist in the diagnosis of DN and have positive significance for the prevention and intervention of DN.Quercetin in Huangkui capsule plays an anti-inflammatory,anti-apoptosis and anti-oxidation role through TNF,Toll-like receptor,NF-κB and other signaling pathways,thus improving DN,which provides a theoretical basis for clinical application of Huangkui capsule in treating DN.