| Objective:Both obese and diabetics are associated with metabolic abnormalities.To identify the differences between obese plus type 2 diabetics and non-obese type 2diabetics,we recruited these two groups of patients and compared circulating levels of amino acids and carnitines between them.Research design and methods:76 male type 2 diabetic patients with BMI>30kg/m~2and 63 male type 2 diabetic patients with BMI<22kg/m~2were selected.Additional selection criteria were:(1)Hyperglycemia was well under control with Hb A1C less than 7%;(2)Patients were without diabetic nephropathy and had normal liver function;(3)Patients were without obvious gastrointestinal diseases.Plasma was collected after12 hours fasting and plasma amino acids and carnitines were determined by high-performance liquid chromatography–tandem mass spectrometry.Results:Plasma levels of phenylalanine,pepper amide,proline,tryptophan,asparagine,leucine,tyrosine,valine,propionylcarnitine and palmitylcarnitine were significantly elevated in obese diabetic compared to nonobese diabetic patients while the levels of glutaric acylcarnitine were lower in obese diabetics.Conclusions:There were significant differences in plasma amino acids and carnitines between obese diabetic and non-obese diabetic patients.Plasma phenylalanine,pepper amide,proline,tryptophan,asparagine,leucine,tyrosine,valine,propionylcarnitine and palmitylcarnitine were increased while the levels of glutaric acylcarnitine were decreased in obese diabetics compared to non-obese diabetics.Whether these phenomena are related to the distinct expression levels of amino acids transporters or m TOR pathway remains to be further explored.Objective: To compare changes of albuminuria levels in patients with glomerular diseases after oral administration with glucose,amino acid powder and protein powder,so as to explore the influences of glucose and amino acids on the onset and development of glomerular proteinuria.Research and design methods: From urology department of our hospital,30 patients were divided into 3 groups.After collecting morning urine samples,patients were administered with oral 50% glucose 50g(group A),0.4g/kg amino acid powder(group B)and 0.4g/kg protein powder(group C),respectively.During this period,patients can only drink water.Collect their urine samples again after 2-3 hours.Additional selection criteria were:(1)Patients were diagnosed with glomerulonephritis or nephrotic syndrome,and pathological types were confirmed by renal biopsy;(3)Patients were without end-stage renal failure,severe trauma,post-surgery,acute cardiovascular events.Fresh urine samples were collected in the morning and 2-3 hours later.Following BCA protein assay and SDS-PAGE,proteins were stained with Coomassie Brilliant Blue.Results: In group A,albuminuria of 2 patients(membranous nephropathy and Ig A nephropathy with hypertensive renal damage,respectively)showed a trend of increase after oral glucose,albuminuria of 2 patients(membranous nephropathy and Ig A nephropathy,respectively)showed a trend of decline,albuminuria of 1 patient with membranous nephropathy had no obvious change,the trend of albuminuria of 3 patients(membranous nephropathy,Ig A nephropathy,focal segmental glomerular sclerosis,respectively)needs to be further determined.In group B,albuminuria of 4 patients(3patients with membranous nephropathy,1 patient with diabetic nephropathy)showed a trend of increase,albuminuria of 1 patient diagnosed with Ig A nephropathy with minimal change showed a trend of decline,albuminuria of 2 patients(both were Ig A nephropathy)had no obviously change,the trend of albuminuria of 1 patient with Ig A nephropathy needs to be further determined.In group C,albuminuria of 6 patients(4patients with membranous nephropathy,1 patient with diabetic nephropathy,1patientswith purpura nephritis)showed a trend of increase,albuminuria of 1 patient with minimal change disease showed a trend of decline,albuminuria of 1 patient with membranous nephropathy showed no significant change,the trend of albuminuria of 6patients(4 patients with Ig A nephropathy,1 patient with diabetic nephropathy,1 patient with membranous nephropathy)needs to be further determined.Conclusions: In group A,different trends of albuminuria in patients may be due to variations in different expression levels of GLUTs,variations in damage of podocyte mitochondria and variations in the activation of glycolysis in the podocyte.In group B and C,most of patients showed an increased trends of albuminuria after administered with amino acids or protein.Albuminuria of patients with Ig A nephropathy showed no obvious change or trends which need to be further determined.Whether these phenomena due to the pathological types mentioned above or not need to be further explored. |
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