Clinical Efficacy Of Dulaglutide In Patients With Type 2 Diabetic Kidney Disease And The Clinical Observation Of Influence On Ferroptosis

Objective To observe the clinical efficacy of dulaglutide in patients with type 2 diabetic kidney disease and influence on ferroptosis,and to explore its renal protective mechanism.Methods Sixty patients with type 2 diabetic kidney disease with poor blood glucose,who were hospitalized in the Second Affiliated Hospital of Anhui Medical University from December 2021 to May 2022 were recruited.Study subjects were divided into the dulaglutide group(30 cases)and the control group(30 cases)by numerical random table method.The dulaglutide group was given routine hypoglycemic drugs combined with dulaglutide,and the control group was given routine hypoglycemic drugs for 24 weeks.Before and after treatment,collect body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),and test fasting blood glucose(FBG),2-hour postprandial blood glucose(2h PG),glycosylated hemoglobin(Hb A1c),total cholesterol(TC),triglycerides(TG),low density lipoprotein cholesterol(LDL-C),uric acid(UA),serum creatinine(SCr),cystatin C(Cys C),estimated glomerular filtration rate(e GFR),urine albumin creatine ratio(UACR),24-hour urinary albumin(24h UAlb).Serum iron was detected by colorimetric method,malondialdehyde(MDA)by fluorometric method,glutathione(GSH)and glutathione peroxidase 4(GPX4)were detected by ELISA method.The data were also statistically analyzed,the paired t test was used for the comparison before and after treatment within the group,and the independent-sample t test was used for the comparison before and after treatment between the two groups.Results1.Before treatment,comparing the general information and clinical related indicators of the two groups,the results showed no significant difference(P>0.05).2.In terms of BMI,blood glucose,blood pressure and blood lipid: after 24 weeks of treatment,the BMI of the control group showed no significant change compared to before treatment,and the difference was not statistically significant(P>0.05);the BMI of the dulaglutide group was lower than before treatment(P<0.05),and significantly lower than that of the control group(P<0.05).The levels of FBG,2h PG and Hb A1 c were lower in both groups than before treatment(P < 0.05),the difference between the groups was not statistically significant(P>0.05).The levels of SBP,DBP,TC,TG and LDL-C were lower in both groups than before treatment(P<0.05),the dulaglutide group was significantly lower than the control group(P<0.05).3.As for renal-related indicators: after 24 weeks of treatment,the levels of UA,SCr,Cys C,UACR and 24 h UAlb decreased in both groups compared to before treatment,the difference was statistically significant(P<0.05),and it decreased significantly in the dulaglutide group compared with the control group(P<0.05).The levels of e GFR increased in both groups compared to before treatment(P<0.05),the dulaglutide group was significantly higher than the control group(P<0.05).4.Regarding ferroptosis-related indicators: after 24 weeks of treatment,the levels of serum iron and MDA decreased in both groups compared to before treatment(P<0.05),the dulaglutide group was significantly lower than the control group [(11.89±5.16 vs 17.01±5.06)umol/L,MDA(6.08±5.00 vs 9.13±4.93)umol/L](P<0.05);the levels of GSH and GPX4 increased in both groups compared to before treatment(P<0.05),the dulaglutide group was significantly higher than the control group[(13.09±5.44 vs10.02±5.14)ng/ml,(79.84±11.55 vs 61.27±10.80)U/ml](P<0.05).Conclusion Dulaglutide can reduce the excretion of urinary albumin in patients with type 2 diabetic kidney disease,improve ferroptosis-related indicators,and significantly reduce BMI,blood pressure,blood glucose,and blood lipids,etc.