Changes Of Metabolite Profile And Proteinuria In Diabetic Nephropathy Patients Treated With Liraglutide

Objective Diabetic nephropathy(DN)is one of the more serious chronic complications of diabetes.Its incidence rate has reached 20% ~ 40% of the diabetic population,and it is the main cause of death of type 1 diabetes,second only to cardiac and cerebrovascular diseases in type 2 diabetes.Diabetic nephropathy is also the leading cause of end-stage renal disease.The disease initially presents with microalbuminuria,then gradually progresses to clinical albuminuria,and eventually causes renal failure for years or even decades.Currently,there is no effective way to delay the progression of diabetic nephropathy in clinical practice,but only by controlling blood sugar and reducing albuminuria,and more and more hypoglycemic drugs can both reduce blood sugar and improve albuminuria.This study analyzed the changes of amino acid metabolites,fatty acid metabolites and albuminuria in diabetic nephropathy patients after the application of Liraglutide.To further explore whether liraglutide can improve insulin resistance and prevent metabolic diseases in type 2 diabetic nephropathy patients,and provide a new idea for the treatment of diabetic nephropathy patients.Methods This study is a retrospective study.A total of 106 patients with type 2 diabetes combined with diabetic nephropathy admitted to endocrinology Department of our hospital from June 2020 to May 2022 were collected.General data and laboratory test results of enrolled patients were collected,including age,diabetes course and BMI.Laboratory test results included fasting blood glucose,insulin,C-peptide,glycosylated hemoglobin and blood lipid: Total cholesterol,triglycerides,high density lipoprotein,low density lipoprotein,Apolipoprotein A,Apolipoprotein B,creatinine,random microalbumin,random microalbumin/creatinine,urea nitrogen,blood creatinine,cystatin C,alanine aminotransferase,aspartate aminotransferase,erythrocyte deposition,anti-insulin antibody,glutamic acid decarboxylase antibody and fatty acid metabolic profile,amino acids Metabolic spectrum.The subjects were divided into diabetic nephropathy stage III group and diabetic nephropathy group IV group according to clinical stages,and the changes of related indexes before and after liraglutide application in each group were observed.Results: The results of this study demonstrated that after the treatment of liraglutide,there were statistically significant differences in the course of disease,random urinary microalbumin,ACR,BUN,serum creatinine,Cys C,apolipoprotein A,AST,and TBIL indexes between the DNⅢstage and the DNⅣstage(p<0.05).In fatty acid metabolism,the differences in ω3/ω6 and triene/tetraene indexes between the two groups were statistically significant(p<0.05).In amino acid metabolism,citrulline,succinylcarnitine,glutarylcarnitine,hydroxymyristoylcarnitine,eicosylcarnitine,phe/ tyr,C4/C3,C5DC/C16,phenylalanine Acid,tyrosine,valine,tyr/cit,(0+2+3+ 16+ 18:1)/cit indexes had statistically significant differences between the two groups(p<0.05).In fatty acid metabolism,there was a statistically significant difference in stearic acid before and after liraglutide treatment in DNⅢstage(p<0.05),and a statistically significant difference in erucic acid in DNⅣstage before and after liraglutide treatment(p<0.05).In amino acid metabolism,there was a statistically significant difference in aspartic acid,lysine,ornithine,piperonamide,free carnitine,acetyl carnitine,propionyl carnitine,isovaleryl carnitine,octadecylcarnitine,phe/tyr,C18:1,C10:1,succinoylcarnitine,hydroxymyristoylcarnitine,docosylcarnitine,tetracosylcarnitine,cit/arg,C4/C2,C8/C10,C3DC/C10,C10:2,C14:2,C18:2,C10:2/C10,adipylcarnitine C6 DC,and C5DC/C8 in DNIII stage before and after liraglutide treatment(p<0.05),and a statistically significant differences in arginine,aspartic acid,histidine,lysine,ornithine,piperonamide,acetylcarnitine,orn /cit,phe /tyr,C5 DC /C16,C18:1,tyrosine,hydroxypalmitoyl carnitine,C3 /C2,C4 /C2,C8 /C10,C10:2,C14:2,C18:2,C10:2/C10 in DNⅣstage before and after liraglutide treatment(p<0.05).Conclusions We found that liraglutide can effectively reduce the blood sugar level of patients with diabetes nephropathy,and can also improve their insulin resistance.In fatty acid metabolism,the application of liraglutide can regulate the disorder of fatty acid metabolism,with the increase of stearic acid in DNⅢand erucic acid in DNⅣ.In the changes of proteinuria,liraglutide can reduce the proteinuria of DNⅢ,but has no effect on DNⅣ..