Association Between Lipopolysaccharides And Type 2 Diabetic Kidney Disease

Objective: Diabetic kidney disease(DKD)is one of the late complications of diabetes.It is a common disease and the main cause of end-stage renal disease,which seriously affects the quality of life of diabetic patients.In addition to the disorder of glucose and lipid metabolism and the abnormality of renal hemodynamics,chronic inflammation is also involved in the development of DKD.Endotoxin,also known as lipopolysaccharides(LPS),is the outermost structure of Gram-negative bacteria.Normally,a small amount of endotoxin produced by intestinal flora enters the blood circulation through the intestinal wall,and is inactivated by Kupffer cells and hepatocytes in the liver.However,the imbalance of intestinal flora in diabetic patients leads to an increase in the proportion of gram-negative bacilli,resulting in more LPS.Endotoxin produced by gastrointestinal microbiome enters the blood circulation through the intestinal wall with increased permeability to stimulate the body to produce chronic inflammation.This study further explored the related factors of type 2 diabetic kidney disease by analyzing the correlation between endotoxin and type 2 diabetic kidney disease.Methods : From January 2019 to December 2019,108 patients with type2 diabetes were randomly selected from the Department of Endocrinology,Affiliated Hospital of Guilin Medical College,aged 45-75.The patients were divided into simple diabetes group and diabetic kidney disease group according to the standard of urinary microalbumin / creatinine.32 healthy people were selected as the control group.Collect the personal data of all the subjects and complete the measurement of basic parameters.All subjects were fasting for 8 hours.Blood and urine samples were collected to detect FPG,TC,TG,LDL-C,HDL-C,Hb A1 c,Scr,Cys-C,hs-CRP,LPS,ACR,and count e GFR.Results:(1)There were significant differences in age,course of disease and family history among DKD group,non DKD group and NC group(P < 0.05).There was no significant difference in gender,smoking history,drinking history and BMI among the three groups(P>0.05).(2)The e GFR in diabetic kidney disease group was significantly lower than that in simple diabetes group(P<0.05);the hs-CRP in diabetic kidney disease group was significantly higher than that in simple diabetes group(P<0.05).(3)The level of Lg LPS in diabetic kidney disease,simple diabetes group and normal control group was significantly different.The level of Lg LPS in diabetic kidney disease group was significantly higher than that in simple diabetes group and normal control group(P<0.05).The level of plasma Lg LPS in simple diabetes group was higher than that in normal control group(P<0.05).(4)Simple linear correlation analysis showed that the level of plasma LPS was positively correlated with the course of disease,(r =0.267,P<0.05);the level of plasma LPS was negatively correlated with age,(r = 0.216,P<0.05);the plasma LPS level was negatively correlated with EGFR,(r =-0.318,P<0.05).There was a positive correlation between plasma LPS and hs-CRP,(r = 0.501,P<0.05).(5)Logistic regression showed that LPS and hs CRP might be the influencing factors of type 2 diabetic kidney disease.Conclusions: The level of plasma LPS in diabetic kidney disease is increased,and plasma LPS is related to EGFR and hs CRP.LPS may participate in the occurrence and development of diabetic kidney disease by activating inflammatory cells and releasing inflammatory factors.