The Role of Nitric Oxide, Lipocalin-2, and Proinflammatory Cytokines on Proteinuria and Insulin Resistance in Type 2 Diabetes Mellitus Subgroups.

IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2024-10-29 eCollection Date: 2024-01-01 DOI:10.2147/IJGM.S478584

Chung Hyun Nahm, Moon Hee Lee, Noriyoshi Fujii, Tatsuyoshi Fujii, Jong Weon Choi

{"title":"The Role of Nitric Oxide, Lipocalin-2, and Proinflammatory Cytokines on Proteinuria and Insulin Resistance in Type 2 Diabetes Mellitus Subgroups.","authors":"Chung Hyun Nahm, Moon Hee Lee, Noriyoshi Fujii, Tatsuyoshi Fujii, Jong Weon Choi","doi":"10.2147/IJGM.S478584","DOIUrl":null,"url":null,"abstract":"Background: Nitric oxide (NO) is a bioactive signaling molecule that mediates various physiological and biological processes. Type 2 diabetes mellitus (T2DM) can be categorized into several subgroups according to fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels. Few studies have closely examined the effect of NO and lipocalin-2 on albuminuria and insulin resistance in T2DM subgroups. This study investigated the role of NO, lipocalin-2, and proinflammatory cytokines on the development of proteinuria and insulin resistance in patients with T2DM subgroups.Methods: A total of 256 subjects, including 191 patients with T2DM and 65 non-diabetic healthy individuals, were evaluated. NO metabolites (NOx), lipocalin-2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured. Patients with T2DM were classified into three subgroups: patients with FPG-defined diabetes (PG-DM), those with HbA1c-defined diabetes (HA-DM), and those who met the criteria for both FPG and HbA1c (PG/HA-DM). The albumin-to-creatinine ratio (ACR) and the homeostasis model assessment of β-cell function (HOMA-B) and insulin resistance (HOMA-IR) were calculated.Results: NOx, lipocalin-2, and TNF-α levels were significantly higher in patients with T2DM than in healthy individuals. Patients with PG/HA-DM had significantly higher NOx levels than those with PG-DM or HA-DM. Of the patients with high NOx levels, patients with lipocalin-2 elevation exhibited higher ACR and HOMA-IR than those without lipocalin-2 elevation. NOx was positively correlated with lipocalin-2, ACR, HOMA-IR, and TNF-α but not with HOMA-B and IL-6. The upper quartile of NOx levels led to a 1.2-fold increase in the risk of albuminuria (odds ratio: 1.215; 95% CI: 1.012-2.418; p < 0.001).Conclusion: NO plays a crucial role in proteinuria and insulin resistance by collaborating with lipocalin-2 and TNF-α, showing significantly higher levels in patients with PG/HA-DM than in those with PG-DM or HA-DM.","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"17 ","pages":"4973-4984"},"PeriodicalIF":2.1000,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531234/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S478584","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Nitric oxide (NO) is a bioactive signaling molecule that mediates various physiological and biological processes. Type 2 diabetes mellitus (T2DM) can be categorized into several subgroups according to fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels. Few studies have closely examined the effect of NO and lipocalin-2 on albuminuria and insulin resistance in T2DM subgroups. This study investigated the role of NO, lipocalin-2, and proinflammatory cytokines on the development of proteinuria and insulin resistance in patients with T2DM subgroups.

Methods: A total of 256 subjects, including 191 patients with T2DM and 65 non-diabetic healthy individuals, were evaluated. NO metabolites (NOx), lipocalin-2, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were measured. Patients with T2DM were classified into three subgroups: patients with FPG-defined diabetes (PG-DM), those with HbA1c-defined diabetes (HA-DM), and those who met the criteria for both FPG and HbA1c (PG/HA-DM). The albumin-to-creatinine ratio (ACR) and the homeostasis model assessment of β-cell function (HOMA-B) and insulin resistance (HOMA-IR) were calculated.

Results: NOx, lipocalin-2, and TNF-α levels were significantly higher in patients with T2DM than in healthy individuals. Patients with PG/HA-DM had significantly higher NOx levels than those with PG-DM or HA-DM. Of the patients with high NOx levels, patients with lipocalin-2 elevation exhibited higher ACR and HOMA-IR than those without lipocalin-2 elevation. NOx was positively correlated with lipocalin-2, ACR, HOMA-IR, and TNF-α but not with HOMA-B and IL-6. The upper quartile of NOx levels led to a 1.2-fold increase in the risk of albuminuria (odds ratio: 1.215; 95% CI: 1.012-2.418; p < 0.001).

Conclusion: NO plays a crucial role in proteinuria and insulin resistance by collaborating with lipocalin-2 and TNF-α, showing significantly higher levels in patients with PG/HA-DM than in those with PG-DM or HA-DM.

查看原文本刊更多论文

一氧化氮、脂联素-2 和促炎细胞因子对 2 型糖尿病亚组蛋白尿和胰岛素抵抗的作用

背景：一氧化氮（NO）是一种生物活性信号分子，可介导各种生理和生物过程。根据空腹血浆葡萄糖（FPG）和血红蛋白 A1c（HbA1c）水平，2 型糖尿病（T2DM）可分为多个亚组。很少有研究仔细研究了 NO 和脂联素-2 对 T2DM 亚组中白蛋白尿和胰岛素抵抗的影响。本研究探讨了氮氧化物、脂联素-2 和促炎细胞因子对 T2DM 亚组患者蛋白尿和胰岛素抵抗发展的作用：方法：共对 256 名受试者进行了评估，其中包括 191 名 T2DM 患者和 65 名非糖尿病健康人。测量了氮氧化物代谢物（NOx）、脂钙素-2、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的水平。T2DM 患者被分为三个亚组：FPG 定义的糖尿病患者（PG-DM）、HbA1c 定义的糖尿病患者（HA-DM）以及同时符合 FPG 和 HbA1c 标准的患者（PG/HA-DM）。计算了白蛋白与肌酐比值（ACR）、β细胞功能稳态模型评估（HOMA-B）和胰岛素抵抗（HOMA-IR）：结果：T2DM 患者的 NOx、脂钙素-2 和 TNF-α 水平明显高于健康人。PG/HA-DM患者的NOx水平明显高于PG-DM或HA-DM患者。在 NOx 水平较高的患者中，脂钙蛋白-2 升高的患者比脂钙蛋白-2 未升高的患者表现出更高的 ACR 和 HOMA-IR。氮氧化物与脂钙蛋白-2、ACR、HOMA-IR 和 TNF-α 呈正相关，但与 HOMA-B 和 IL-6 无关。NOx水平的上四分位数导致白蛋白尿的风险增加了1.2倍（几率比：1.215；95% CI：1.012-2.418；P < 0.001）：通过与脂联素-2和TNF-α合作，NO在蛋白尿和胰岛素抵抗中发挥着重要作用，PG/HA-DM患者体内的NO水平明显高于PG-DM或HA-DM患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.