| Objective:1.Collect the pathological types and clinical indicators of all patients who underwent renal biopsy in our hospital from 2019 to 2021,analyze the composition of the pathological types,and compare the differences in clinical indicators of each group through statistical analysis,to find out the difference between diabetic nephropathy and non-diabetic nephropathy.Basis;2.To study the expression of glycogen synthase kinase-3β(GSK-3β)in renal tissue of diabetic kidney disease(DKD),DM+MN and membranous nephropathy(MN).The correlation between GSK-3β expression and various clinical indicators was analyzed to explore the diagnostic value of GSK-3β in diabetic nephropathy and non-diabetic nephropathy.Methods:1.The clinical,laboratory data and pathological diagnosis of all patients who underwent renal biopsy in our hospital from January 2019 to December 2021 were collected and analyzed retrospectively(n=1427),and diabetes mellitus(n=201)Cases)were divided into DKD(Diabetic kidney disease,DKD)group,DKD+NDRD group,and non-diabetic renal diseases(NDRD)group according to pathological types;FBG,Hb A1 c,HB,presence or absence of DR,Whether there was any difference in Scr,eGFR,ALB,TG,LDL-C,HDL-C,24-hour urine protein quantification and other indicators.2.36 patients who underwent renal biopsy in our hospital from 2019 to 2021 were randomly selected as the research objects,and were divided into diabetic nephropathy group(n=17cases)and DM+MN(n=9 cases)according to the presence or absence of diabetes and pathological diagnosis)and pure membranous nephropathy group(n=10 cases),and their clinical,laboratory data,and pathological diagnosis were collected,and the differences in clinical indicators of each group were compared;immunohistochemical staining was used to determine the expression of GSK-3β in kidney tissue The correlation between GSK-3β expression and clinical indicators was analyzed.Results:1.There were 201 cases of diabetes mellitus in the renal biopsy patients in our hospital: 49 cases(24.38%)in the DKD group,14 cases(6.67%)in the DKD+o NDRD,and 138 cases(68.66%)in the NDRD group;201 cases of diabetes and There was no significant difference in the composition ratio of membranous nephropathy in 1216non-diabetic patients(P>0.05).By analyzing and comparing the DKD group and the NDRD group,there was a statistically significant difference in the duration of DM less than 5 years(P < 0.001),but there was no statistical difference in hematuria between the two groups.Glycosylated hemoglobin(Hb A1c),serum creatinine(Scr),glomerular filtration rate(GFR),triglycerides(TG)in DKD group,DKD+NDRD group,The between-group comparison in the NDKD group was statistically significant(P < 0.05).Pairwise comparison of the three groups found that the Hb of the DKD group was significantly lower than that of the other pathological groups;the Hb A1 c of the DKD group and the DKD+NDRD group were higher than those of the NDKD group;the Scr of the DKD group was significantly higher than that of the NDKD group,while theGFR was significantly higher in the DKD group.lower than the NDKD group,and there was no statistical difference between the other groups;TG means that the NDKD group was higher than the DKD group,and the difference in diabetic retinopathy(DR)among the three groups was statistically significant(P < 0.05).It was shown that 77.78% of patients with DR in DKD group were higher than DKD+NDRD group and NDKD group(P<0.05),and DKD+NDRD group was also higher than NDKD group(P <0.05).2.17 cases in the DKD group,9 cases in the DM+MN group,and 10 cases in the pure MN group were randomly selected.The percentages of males in each group were:52.90%,77.80%,60.00%,and the ages were: 45.94±12.06 years old,respectively.55.33±9.38 years old,45.90±14.00 years old;the duration of diabetes in the DKD and DM+MN groups were 96.00(48.00,138.00)months and 0.50(0.00,108.00)months,respectively,and there was no statistical difference between the groups;Glycated hemoglobin was 6.80(6.30,8.95)%,6.80(6.40,8.15)%,the patients with diabetic retinopathy in the DKD group accounted for 88.20%,and the patients with edema in each group accounted for: 70.6%,66.80%,90.00%.Through the comparison,it was found that the fasting blood sugar(FBG),BUN,Scr,GFR,hemoglobin(Hb),and serum potassium were statistically significant among the three groups(P<0.05): DKD group,The FBG of the DM+MN group was higher than that of the pure MN group(P <0.05);the blood BUN and Scr of the DKD group were significantly higher than those of the DM+MN group and the pure MN group(P <0.05);the DKD group The glomerular filtration rate of the patients was lower than that of the DM+MN group and the pure MN group(P <0.05),and the Hb of the DKD group was lower than that of the DM+MN group and the MN group(P<0.05).The serum potassium of DM+MN group was higher than that of DM+MN group(P<0.05),but there was no significant difference with MN group.3.The expression of total GSK-3β in glomeruli was statistically significant in DKD group,DM+MN group,and pure MN group.The results showed that the expression of total GSK-3β in DM+MN group was higher than that in pure MN group.There was no difference between the MN group and the DKD group,but there was no difference between the DKD group and the pure MN group;and there was no significant difference in the expression of phosphorylated glycogen synthase kinase-3β(p GSK-3β)among the groups.(P > 0.05).4.The expression of GSK-3β has no significant correlation with the clinical indicators.Conclusion:1.The pathological types of renal biopsy in our hospital in the past 3 years are mainly membranous nephropathy in both diabetic and non-diabetic people,and DKD,Ig AN,FSGS,and MCD are ranked after MN in people with diabetes.;In patients without diabetes,the rankings were roughly MN,Ig AN,MCD,FSGS,and acute interstitial kidney injury.There was no significant difference in the composition of membranous nephropathy between diabetic patients and non-diabetic patients.2.The probability of DKD is higher when the duration of diabetes is more than 5years,the prevalence of Dr is high,HBA1 C and SCR are high,and eGFR is low.3.The total expression of GSK3β in kidney tissue of DM+MN group was higher than that of DKD group and isolated MN,which may suggest that GSK3β plays a stronger role in the pathogenesis of DM+MN. |
