Effect Of Calcitriol And Tripterygium Glycosides On Level Of TGF-?1 In Patients With Diabetic Nephropathy

Objective:To explore the effect of losartan combination therapy respectively withcalcitriol and tripterygium glycosides on Level of transforming growth factor ?1(TGF-?1)in patients with early type 2 diabetic nephropathy(DN),provide the basis for the treatment of DN.Methods:90 patients with early type 2 DN,admitted to nephrology of the first affiliated hospital of wannan medical college between June 2014 and September2015,were included and tested their serum concentrations of TGF-?1 by enzyme-linked immunosorbent assay method,liver and kidney functions,lipids,fasting glucose,urinary protein and other metabolic and biochemical indicators.Pations were randomized into group losartan(group A;n=30),group losartan combined with calcitriol(group B;n=30)and group losartan combined with tripterygium glycosides(group C;n=30)by following the random number table.Based on strict control of blood glucose,group A received losartan(50 mg,qd);group B received losartan combined with calcitriol(0.25 ?g,qd);group C received losartan combined with tripterygium glycosides(10 mg,tid).The changes of serum TGF-?1 were observed after 12 weeks.24 h urinary protein excretion,TC,TG,Scr,BUN,FPG were included.SPSS 18.0 statistics software were applied to analyze the data.During follow-up adverse events was recorded.Results:The level of serum TGF-?1 and 24 h UAER were significantly decreased compared with baseline levels in all groups at follow-up end(P<0.05),group B was superior to group C,group B and group C were superior to group A.FPG and Hb A1 c were decreased from baseline levels in Group B(P<0.05).The incidence of adverse reactions was no significant difference among the groups(P>0.05).Conclusions:1.Losartan,losartan combined with calcitriol,losartan combined with tripterygium glycosides can reduce respectively the expression of serum TGF-?1 in patients with DN,attenuate 24 h UAER and renal damage,delay the progress of type 2DN.The effect of losartan combined with calcitriol group is optimal;it may be associated with suppression of inflammation and immunity,protection podocytes,expression of serum TGF-?1 decreased.2.Losartan combined with calcitriol can reduce FPG and Hb A1 c levels,The mechanism may be involved in the body's metabolic pathway.3.Serious adverse reactions are not observed in all groups;basing on correcting metabolic disorders,calcitriol and tripterygium glycosides can be used for therapy of early type 2DN.