Intensive insulin therapy decreases urinary MCP-1 and ICAM-1 excretions in incipient diabetic nephropathy.
BACKGROUND
Nowadays, intensive insulin treatment has been widely used in type 2 diabetics who have poor control of blood glucose, to reduce the risk of chronic complications of diabetes. Recently, some scholars have paid more attention to the pivotal role of inflammation involved in type 2 diabetes and its complications. Monocyte chemoattractant protein-1 (MCP-1) and intercellular adhesion molecule-1 (ICAM-1), which are two important inflammatory chemokines, have been documented to participate in the onset and development of type 2 diabetes and its complications, such as diabetic nephropathy (DN).


METHODS
In the current study, we recruited 30 type 2 diabetics with microalbuminuria to be treated with multiple insulin injections daily for 2 weeks. Random spot urine samples (corrected for creatinine-Cr) were collected for the examination of urinary MCP-1, ICAM-1 and albumin (Alb) levels before and after the intensive insulin therapy. Changes in their levels were observed to test the hypothesis that type 2 diabetes with microalbuminuria is associated with elevated urinary concentrations of MCP-1 and ICAM-1, and intensive insulin therapy can result in a decline of Alb by reducing the inflammatory reaction.


RESULTS
The urinary MCP-1/Cr and urinary ICAM-1/Cr ratios in type 2 diabetic patients with microalbuminuria were much higher than those in normal controls, and intensive insulin treatment could decrease significantly the urinary MCP-1/Cr, ICAM-1/Cr and Alb/Cr ratios in type 2 diabetics with microalbuminuria.


CONCLUSIONS
Intensive insulin treatment may protect against renal injury in early DN by reducing the urinary MCP-1 and ICAM-1 excretions.
Ye
S D
SD
Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China. ysd6464@yahoo.com.cn
Zheng
M
M
Zhao
L L
LL
Qian
Y
Y
Yao
X M
XM
Ren
A
A
Li
S M
SM
Jing
C Y
CY
D000419:Albuminuria / Q000652:urine*; D001786:Blood Glucose / Q000378:metabolism; D018932:Chemokine CCL2 / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000652:urine*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000652:urine*; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D018932:Chemokine CCL2; D018799:Intercellular Adhesion Molecule-1