Background: This study aimed to investigate the relationship between endothelial nitric oxide synthase (eNOS) 4b/a gene polymorphism and renal interstitial fibrosis in patients with diabetic nephropathy (DN) via a meta-analysis, in the hope of providing guidance for the genotypic detection of DN.Methods: The Boolean logic search method was adopted. A literature search of PubMed, Medline, CNKI, and other databases from inception to June 2020 was performed using the search terms "eNOS 4b/a", "diabetes", "renal interstitial fibrosis", and "kidney disease". Literatures with a DN group, a nonnephropathy diabetic group, and a normal control group were screened. Review Manager software was employed to perform the meta-analysis.Results: A total of 13 articles were included in the meta-analysis, the majority of which had a low risk of bias (i.e., medium and high quality). The results of the meta-analysis indicated that the genotypic distribution frequency of eNOS4bb in patients with DN was significantly lower than that in the nonnephropathy diabetic group (Z=3.19, P=0.001). The genotypic distribution frequency of eNOS4aa was significantly higher in non-nephropathy diabetic patients than in the normal control group (Z=2.57, P=0.01).The genotypic distribution frequency of eNOS4ba was not statistically different between patients with DN and non-nephropathy diabetic patients (Z=1.45, P=0.15). The genotypic distribution frequency of eNOS4bb in DN patients was significantly lower than that in the normal control group (Z=3.03, P=0.002); however, the genotypic distribution frequency of eNOS4ba was significantly greater than that of the normal controls (Z=2.36, P=0.02), as was that of eNOS4aa (Z=2.34, P=0.02).Conclusions: Genotypic polymorphism of eNOS 4b/a was closely related to DN. Moreover, the genotypic distribution frequency of eNOS4bb in DN renal interstitial patients was lower than that in non-nephropathy diabetic patients and normal controls.
Background: Diabetic nephropathy is a common complication in diabetic patients, with a high rate of disability and mortality. This study aims to explore the changes in serum advanced glycation end products (AGEs), matrix metalloprotein-2 (MMP-2), and urinary microalbuminuria (mALB) in diabetic nephropathy and their predictive value for heart failure. Methods:The 134 patients with diabetic nephropathy treated in our hospital from January 2014 to December 2017 were enrolled and divided into two groups resulting in 64 cases in an observation group with heart failure, and 70 cases without heart failure in a control group. In addition, 80 patients with simple diabetes who were treated during the same period were selected as the simple diabetes group. Levels of AGEs, MMP-2, and mALB between the groups were compared, risk factors affecting diabetic nephropathy patients with heart failure were analyzed, and an ROC curve was drawn to evaluate the predictive value of AGEs, MMP-2, and mALB for heart failure Results: The levels of AGEs and mALB in the diabetic nephropathy group were significantly higher than those in the simple diabetes group, and the levels of MMP-2 were significantly lower than those in the simple diabetes group (P<0.05). The levels of AGEs and mALB in the observation group were significantly higher than those in the control group, and the levels of MMP-2 were significantly lower than that in the control group (P<0.05). Smoking history hypertension history, blood creatinine (abnormal increase), blood uric acid (abnormal increase), AGEs (abnormal increase), MMP-2 (abnormal decrease), and mALB (abnormal increase) were independent risk factors affecting diabetic nephropathy patients with heart failure. The area under the ROC curve of AGEs, MMP-2, mALB, and their combined detection were: 0.821, 0.909, 0.897, and 0.991, respectively, showing the area under the curve of combined detection to be the largest.Conclusions: AGEs, MMP-2, and mALB have high predictive value for heart failure in patients with diabetic nephropathy. Their sensitivity and specificity are high, indicating they may hold considerable clinical value.
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