Analysis on difference in gastrointestinal hormone levels of patients with the history of diabetes and concurrent nephropathy and study on the role of liraglutide.

OBJECTIVE: To compare the difference in the gastrointestinal hormone levels of the patients with the history of diabetes and concurrent nephropathy and investigate the clinical effect of liraglutide in the treatment of diabetic nephropathy (DN).

PATIENTS AND METHODS: 42 cases of patients with DN admitted in our hospital from April 2010-May 2015 were selected and divided into phase I-II group (group A, n = 22) and phase III-IV group (group B, n = 20) according to DN phases and 20 cases of patients with diabetes rather than nephropathy admitted in our hospital during the same period were selected as the control group, all of whom underwent the routine biochemical test and gastrointestinal hormone test, the differences in gastrin (GAS), motilin (MTL) and glucagon (GLC) of DN patients were compared at different phases, the gastric emptying test was carried out on them and the gastric emptying time was recorded. All patients were treated with liraglutide and the changes in fasting blood glucose (FBG), glycosylated hemoglobin (HbAlc), serum creatinine (Cr), blood urea nitrogen (BUN), insulin (FINS) and insulin resistance level (HOMA-IR) were tested before treatment and after 10 weeks' treatment, the changes in the tumor necrosis factor (TNF-α), interleukin -6 (IL-6) and transforming growth factor (TGF-β1) were determined, and the change in the gastrointestinal hormone levels of patients was recorded after treatment.

RESULTS: (1) the GAS, MTL, GLC and gastric emptying time in group B were higher than those in group A and the control group (p < 0.05), and the above indicators in group A were higher (p < 0.05); (2) after 10 weeks' treatment, the gastrointestinal hormone levels in the three groups were reduced and the gastric emptying time was shortened, the difference was statistically significant (p < 0.05) compared with those before treatment, after 10 weeks' treatment, the GAS, MTL, GLC and gastric emptying time in group B were higher than group A and the control group, those in group A were higher than control group (p < 0.05); (3) before treatment, the comparative differences in FBG, HbAlc, FINS and HOMA-IR among the three groups were not statistically significant (p > 0.05), and after 10 weeks' treatment, the differences in FBG, HbAlc and HOMA-IR among three groups were reduced and FINS was increased, the difference in those between before treatment and after treatment was statistically significant (p < 0.05) and the comparative difference among the three groups was not statistically significant (p > 0.05); (4) before treatment, Cr and BUN levels in group A and group B were higher than the control group (p < 0.05), after 10 weeks' treatment, the Cr and BUN levels among three groups were significantly decreased (p < 0.05), Cr and BUN in group A and group B were higher than the control group, cr and BUN levels in group B were higher than group A (p < 0.05); (5) before treatment, the difference by comparing IL-6, TNF-α and TGF-β1 among three groups were not statistically significant (p > 0.05), after 10 weeks' treatment, the indicators in the three groups were decreased significantly (p < 0.05), but the comparative difference among the three groups were not statistically significant (p > 0.05); (6) the difference by comparing the efficiencies among the three treatment was not statistically significant (p > 0.05).

CONCLUSIONS: There are some correlations between the gastrointestinal hormone levels and the degree of renal impairment of DN patients. Good results will be achieved by applying liraglutide in intervention with different phases of DN and DM patients, which cannot only regulate the gastrointestinal hormone levels and lower the blood sugar levels of patients, but can also reduce the insulin resistance and delay the process of renal damage.