Synergistical action of the β2 adrenoceptor and fatty acid binding protein 2 polymorphisms on the loss of glomerular filtration rate in Chinese patients with type 2 diabetic nephropathy

Correlation between Blood Oxygen Level-Dependent Magnetic Resonance Imaging Images and Prognosis of Patients with Multicenter Diabetic Nephropathy on account of Artificial Intelligence Segmentation Algorithm

This study was aimed to analyze the correlation between blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) images and prognosis of patients with diabetic nephropathy (DN) based on artificial intelligence (AI) segmentation algorithm, so as to provide references for diagnosis and treatment as well as prognosis analysis of patients DN. In this study, a kernel function-based fuzzy C-means algorithm (KFCM) model was proposed, and the FCM algorithm based on neighborhood pixel information (BCFCM) and the FCM algorithm based on efficiency improvement (EnFCM) were introduced for comparison to analyze the image segmentation effects of three algorithms. The results showed that the partition coefficient (V_pc) and partition entropy (V_pe) of the KFCM algorithm were 0.801 and 0.602, respectively, which were better than those of the traditional FCM, BCFCM, and EnFCM algorithm. At the same time, the effects of correlation between renal cortex R2∗ (RC-R2∗), renal medulla R2∗ (RM-R2∗), renal cortex D (RC-D), renal medulla D (RM-D) and renal function on the prognosis were compared. The results showed that the correlation coefficients between RC-R2∗, RM-R2∗, RC-D, RM-D and renal function were 0.57, 0.62, 0.49, and 0.38, respectively; among them, RC-R2∗ and RM-R2∗ were negatively correlated to the estimated glomerular filtration rate (eGFR), and the difference between the groups was statistically significant (P <0.05). Among the factors affecting the prognosis of DN patients, the GFR, hemoglobin (Hb), RC-R2∗, RM-R2∗, and RC-D were all related to the prognosis of DN, and the difference between groups was statistically obvious (P <0.05). It suggested that the KFCM algorithm proposed in this study showed the relatively best segmentation effect on BOLD-MRI images for DN patients; an increase in R2∗ indicated a poor prognosis, and an increase in the RC-D value indicated a better prognosis.

Association of polymorphism genes , , and with risk of hyperinsulinism and insulin resistance in the Kazakh population

Hyperinsulinism and insulin resistance are closely associated with several common diseases including type 2 of diabetes, cardiovascular diseases, and metabolic syndrome. The present study aimed to determine the association between hyperinsulinism, insulin resistance and the polymorphism of genes, including angiotensin II receptor type 1 (AGTR1), angiotensinogen (AGT), β2-adrenoreceptor (ADRB2) and lipoprotein lipase (LPL), in the Kazakh population. The design of the current research was a case-control study, involving 460 subjects (age range, 18-65 years). For every subject, plasma glucose, insulin, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, apolipoprotein B and apolipoprotein A1 were examined. Moreover, reverse transcription-quantitative PCR was conducted to detect the polymorphism genes LPL Ser447Ter, ADRB2 Gln27Glu, AGT Thr174Met and AGTR1 A1166C. Hyperinsulinism was considered when the insulin level was elevated >24.9 IU/ml. The homeostasis model assessment insulin resistance (HOMA-IR) was used to evaluate insulin resistance. The subjects were divided into hyperinsulinism (17 men and 24 women) and normal level insulin (214 men and 205 women) groups, which were also split into insulin resistance group (HOMA-IR >2.7; 80 men and 105 women) and those without insulin resistance group (151 men and 124 women). The results suggested that LPL Ser447Ter (rs328) allele G was associated with a lower risk of hyperinsulinism (P=0.037). Furthermore, polymorphisms of genes ADRB2 Gln27Glu (rs1042714), AGT Thr174Met (rs4762) and AGTR1 A1166C (rs5186) were not associated with hyperinsulinism and insulin resistance in the Kazakh population. No interaction was identified between LPL Ser447Ter, ADRB2 Gln27Glu, AGT Thr174Met and AGTR1 A1166C. Therefore, the results indicated that haplotype combinations were not associated with insulin resistance.

Genetic and Epigenetic Studies in Diabetic Kidney Disease

Chronic kidney disease is a worldwide health crisis, while diabetic kidney disease (DKD) has become the leading cause of end-stage renal disease (ESRD). DKD is a microvascular complication and occurs in 30–40% of diabetes patients. Epidemiological investigations and clinical observations on the familial clustering and heritability in DKD have highlighted an underlying genetic susceptibility. Furthermore, DKD is a progressive and long-term diabetic complication, in which epigenetic effects and environmental factors interact with an individual’s genetic background. In recent years, researchers have undertaken genetic and epigenetic studies of DKD in order to better understand its molecular mechanisms. In this review, clinical material, research approaches and experimental designs that have been used for genetic and epigenetic studies of DKD are described. Current information from genetic and epigenetic studies of DKD and ESRD in patients with diabetes, including the approaches of genome-wide association study (GWAS) or epigenome-wide association study (EWAS) and candidate gene association analyses, are summarized. Further investigation of molecular defects in DKD with new approaches such as next generation sequencing analysis and phenome-wide association study (PheWAS) is also discussed.

Nocardiosis in Kidney Disease Patients under Immunosuppressive Therapy: Case Report and Literature Review

The increased use of novel and powerful immunosuppressive drugs in kidney diseases may concomitantly expose the patients to higher risk of opportunistic infections, some of which still remain underdiagnosed thus mishandled. As such, we recently had a less prepared encounter of pulmonary nocardial infection in an ANCA-associated renal vasculitis patient under steroid therapy. Despite the use of broad-spectrum antimicrobials including micafungin, the infection was still unbridled and eventually culminated in lethal brain abscess. We thus chose to renew the knowledge of the clinical features, imaging manifestations, differential diagnosis, specific laboratory tests and unique treatment about this rare infection in kidney diseases patients under immunosuppressive therapy. In addition, CT images of easily confused pulmonary lesions superimposed on kidney diseases were also retrieved from our depository. Moreover, impaired renal function as a risk factor for infection and pharmacological options for the treatment were also focused. By sharing our hard-learnt experience and reviewing the literatures, our report may contribute to the awareness among the clinicians in general and nephrologists in particular of this rare disease in susceptible patients and facilitate a swift thus life-saving treatment.