Background: Diabetic nephropathy (DN) is a microvascular complication of Diabetes Mellitus (DM) and the prevalence of which is increasing in every year. Monitoring of Vitamin D status in diabetic nephropathy patients is important, as the deficiency of vitamin D appears as a risk factor for the development of diabetic nephropathy. Studies evaluating the role of vitamin D in DN are few. Conflicting data is available on the correlation between vitamin D and Diabetic Nephropathy. Studies revealed the sample population is Vitamin D deficient. Therefore, it is important to understand the correlation of Vitamin D with severity of Diabetic nephropathy and its role in fibrogenesis. The aim of this study is to analyse vitamin D status in different stages of type 2 diabetic nephropathy and its correlation with transforming growth factor beta-1. Methods: A 1.5-year cross-sectional study of 120 diabetic patients, 60 with nephropathy and 60 without nephropathy patients enrolled to MES Medical College. Patients with heart, liver, or thyroid disease, as well as those on dialysis, were excluded from the study. The VITROS 5600 integrated system were used to measure fasting blood sugar (FBS), HbA1c, creatinine and vitamin D. Transforming Growth Factor Beta-1 (TGF-β1) is measured using ELISA technique. According to HbA1c and estimated glomerular filtration rate (eGFR) values, the study population is divided into two groups. The statistical package for the social sciences (SPSS) software was used to conduct the analysis. The level of significance was calculated at 95%. Results: The level of vitamin D in diabetic patients with nephropathy is much lower than in diabetic patients without nephropathy. In diabetic nephropathy patients, serum creatinine, urea, HbA1c and TGF-β1 exhibited a highly significant negative correlation with vitamin D status, but eGFR showed a highly significant positive correlation. Conclusion: Vitamin D status has been found to be poor in all diabetic patients, with a greater drop in diabetic nephropathy patients. In diabetic nephropathy patients, serum creatinine, urea, HbA1c and TGF-β1 exhibited a highly significant negative association with vitamin D status, but eGFR showed a highly significant positive link. Deficiency of vitamin D have role in the development and severity of DN, and showed a highly significant correlation with the regulator of fibrosis, TGF-β1. This finding indicates that vitamin D couldbe an important factor for development and progression of Diabetic nephropathy. So supplementation of vitamin D may slow down progression of DN.
Introduction: Alpha Klotho protein monitoring in diabetic nephropathy patients is important because the deciency appears to be a risk factor for the development and progression of diabetic nephropathy and thus has prognostic value. There is conicting evidence regarding the relationship between Alpha Klotho protein and brogenesis in diabetic nephropathy. A 2-year cross-s Methods: ectional study of 120 diabetic patients, with and without nephropathy enrolled at MES Medical College. Alpha Klotho protein and the brogenesis regulator, TGF-β1 were measured using ELISA. Results: Conclusion: In diabetic nephropathy patients, Alpha-Klotho protein had a signicant negative correlation with TGF-β1 and eGFR. Alpha-Klotho protein levels have been found to be lower in diabetic nephropathy patients and signicantly related to the severity of the disease. Alpha-KL protein also correlated signicantly with the marker of brogenesis, TGF- beta 1. So it has a value as a prognostic marker and role in preventing brogenesis in diabetic patients.
Background: Glycemic control, lipid control and other modifiable risk factor, is very important to prevent complications of type 2 diabetes. The objective of this study was to analyze glycemic control, lipid profile, BP and find the correlation of these parameters in the diabetic population of North Kerala.Methods: This was a cross sectional study among the type 2 diabetic patients with 40-60 years of age, and those without any cardiac, renal, liver, and thyroid dysfunction. Fasting blood sugar, BP, HbA1c and lipid profile were assessed by VITROS 5600 integrated system. The study population was grouped in to two based on their glycemic control (HbA1c ≥7% and HbA1c <7%). Statistical analysis was performed by SPSS software. The comparison of variables age, BP, FBS, HbA1c, total cholesterol, LDL, HDL, TG, and TG/HDL was tested using independent student t test. The correlations between the variables were analyzed using Pearson correlation coefficient. P values less than 0.05 were considered significant.Results: There was a significant positive correlation between DBP and poor glycemic control group (t=2.35, p=0.0102). Fasting blood sugar (p≤0.00001), total cholesterol (p=0.0031), triglycerides (p≤0.00001), LDL (p=0.0051), HDL (p=0.0010) and TG/HDL (p≤0.00001) also were significantly higher in this group. Age or gender showed no correlation with HbA1c and BP.Conclusions: This study shows highly significant positive correlation between TG/HDL and poor glycemic control. It appears the degree of hypertension is not correlated with HbA1c, but significantly correlated with lipid profile especially among those with poor glycemic control.
Background: Timely control of hemoglobin A1c (HbA1c) level is very important in patients with diabetic kidney disease. Diabetic nephropathy brings changes in mineral metabolism. The changes in calcium and phosphorous level is a reason for increased morbidity or decreased quality of life in these patients. Conflicting reports are available on serum calcium level and decline in kidney function. This study is to analyse the changes in calcium and phosphorous level in different stages of diabetic nephropathy and its correlation with glycated haemoglobin.Methods: A cross sectional study with 60 diabetic nephropathy patients admitted in MES Medical College for a period of 1.5 years. Patients with cardiac, liver, thyroid dysfunction, under dialysis were excluded from the study. Fasting blood sugar, HbA1c, calcium, phosphorous, creatinine were assessed by VITROS 5600 integrated system. The study population is divided into groups by two different means, according to HbA1c and estimated glomerular filtration rate (eGFR) value. Statistical analysis was performed by statistical package for the social sciences (SPSS) software. Level of significance calculated at 95%.Results: eGFR value showed a highly significant correlation with age (p=0.016), creatinine (p≤0.00001), calcium (p≤0.00001), phosphorous (p≤0.00001) and HbA1c (p=0.00001). There was no significant difference in creatinine and eGFR between male and female subjects. Only eGFR (p=0.0396) showed a significant difference between poor and good glycaemic control groups.Conclusions: This study shows highly significant correlation between the decreased eGFR hypocalcaemia, hyperphosphatemia, increased serum creatinine level and HbA1c. Strict glycemic control is crucial in maintenance of mineral homeostasis and prevention of blood calcium, phosphorous abnormalities.
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