Effect of levocarnitine combined with engegligin on early diabetes nephropathy
Objective To investigate the impacts of levocarnitine combined with empagliflozin on urinary protein,estimated glomerular filtration rate(eGFR),serum soluble intercellular cell adhesion molecule-1(sICAM-1)and C1q tumor necrosis factor related protein 9(CTRP9)levels in patients with early diabetes nephropathy(DN).Methods Ninety patients with DN(Mogensen Staging Phase Ⅱ-Ⅲ)admitted to the First Affiliated Hospital of Henan University of Science and Technology from April 2021 to August 2022 were randomly grouped into control group(45 cases)and study group(45 cases).The control group was given empagliflozin,1 tablet/time,1 time/d,for 3 months;the study group was given levocarnitine,1 tablet/time,3 times/d,in addition of empagliflozin as in the control group for 3 months.The clinical data of patients were collected,and the clinical efficacy,renal function indicators,inflammatory indicators,changes in serum sICAM-1,CTRP9 levels and the incidence of adverse reactions were compared between the two groups.Results Compared with the control group(77.78％),the total effective rate of the study group(95.56％)was obviously increased,the difference was statistically significant(x2=4.712,P=0.030).After treatment,the 24-hour urinary total protein[(92.84±20.28)mg vs.(80.32±18.44)mg],urea nitrogen[(9.06±2.01)mmol/L vs.(7.92±1.78)mmol/L],serum creatinine[(82.33±20.37)µmol/L vs.(65.83±18.05)µmol/L],serum sICAM-1[(6.62±1.36)pg/mL vs.(5.38±1.01)pg/mL],interleukin-6(IL-6)[(7.63±1.74)pg/mL vs.(6.45±1.36)pg/mL]and IL-1 β[(3.17±0.62)pg/mL vs.(2.22±0.36)pg/mL]of DN patients in the two groups were obviously decreased(t=3.064,2.848,4.067,4.910,3.584,8.889;all P＜0.01),while eGFR[(88.68±19.35)mL/(min·1.73 m2)vs.(105.38±21.36)mL/(min·1.73 m2)]and serum CTRP9[(3.39±0.72)pg/mL vs.(4.17±0.86)pg/mL]were obviously increased(t=3.887,4.665;all P＜0.001),and the improvement effects of the above indicators in the study group were more obvious(P＜0.05).Conclusions Levocarnitine combined with empagliflozin was effective in the treatment of early DN patients.It could reduce the expression levels of serum sICAM-1 and inflammatory factors,increase the expression level of CTRP9,and improve the renal function of patients.
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