Influence Of Metformin On UAE CysC And Hcy In The Patients Of Non End-Stage Diabetic Nephropathy

Objective:There is still a dispute in how to use metformin in the patients of diabetes nephropathy.In this paper,we surveyed the variation of urinary albumin excretion(UAE),cystatin C and homocysteine in different non end-stage diabetic nephropathy patients before and after the use of metformin to know the impact of metformin on the UAE CysC Hcy and the relationship of each other to guide the clinical use of the metformin.Methods:To select the subjects by the 1999 WHO Diabetic Diagnostic standard.28 normal control were designed,which were selected from healthy subjects in the regular physical examination center. According to the levels of UAE,104 patients of non end-stage type 2 diabetes mellitus were divided into non albuminuria group (UAE) (UAE≤20ug/min),microalbuminuria group (MIAU) (20ug/min0.05).Though there was a decline in UAE of the INS+MET subgroups,no statistical differences(P>0.05). 3.Before the intervention,the concentration of Hcy of three groups were(13.06±2.12)μmol/L,(13.08±1.89)μmol/L, (14.11±0.33)μmol/L,which were all higher than that of the normal control group(P<0.05).The levels of Hcy in two subgroups of every group were raised as the rise of the urine albumin(P<0.05).After the intervention,there were still no differernces in Hcy in INS subgroup of every group,but decreased in INS+MET subgroup(P<0.05).Compared INS+MET subgroup with INS subgroup,the level of Hcy were reduced(P<0.05).Compared with the normal control group,there were still statistical differences.4.Pearson correlated analysis showed that Hcy were correlated positively with Cr,CysC(r 0.074,0.152 respectively,all P<0.05),not correlated with TQTCH,LDL-C(P＞0.05).In multivariant stepwise regression analysis model,after control BMI,UAE,age,sex,blood fats,Hcy remained relationship with Cr,CysC(all P＜0.05)independtly.Conclusion:1.In the patients of type 2 diabetes mellitus,compared INS with INS+MET,there were no increase in CysC,Cr,Ccr in the MIAU and MAAU,UAE had tended to decline.which suggest that metformin may have no harm to non end-stage diabetic nephropathy and the kidney function.2.The level of Hcy in the patients of type 2 diabetes mellitus were higer than that in the normal control,which were more obvious in the patients of the high urinary albumin level;and Hcy were correlated with Cr,CysC.Which suggest that the hyperhomocysteinemia has relationship with non end-stage the diabetes mellitus and non end-stage diabetic nephropathy.3.After the intervention of INS+MET,Hcy was reduced;and was lower that that of the INS subgroups of every group and normal control group(P<0.05).Which suggest that metformin may reduce the Hcy of the non end-stage diabetic nephropathy.