Effects of liraglutide and selegiline on renal hemodynamics and NLR,Cys-C,and MCP-1 in patients with early stage type 2 diabetic nephropathy

Hu Yang; Li Liping; Yan Jianjun; Zhang Nan; Cheng Muzi; Zhang Lisha; Zhang Wenjing; Cheng Ling

doi:10.3969/j.issn.1671-6450.2024.03.013

Abstract：Objective To investigate the effects of liraglutide and selegiline on renal hemodynamics and neutro-phil/lymphocyte ratio(NLR),serum cystatin C(CysC),and monocyte chemoattractant-1(MCP-1)in patients with early-onset type 2 diabetic nephropathy(T2DN).The effects of NLR,serum cystatin C(CysC),and monocyte chemokine-1(MCP-1).Methods One hundred and ten patients with early T2DN admitted to the Department of Endocrinology I of the First Hos-pital of Handan City from December 2020 to December 2022 were selected as study subjects.The patients were divided into observation group(n=55)and control group(n=55)according to randomnumber ranking method.The control group was treated with selegiline and the observation group was treated with liraglutide combined with selegiline for 12 weeks.We compared the efficacy,glycemic indexes,renal hemodynamic indexes in both renal aorta(MRA)and interlobar artery(IRA),NLR,Cys-C,MCP-1,and the occurrence of adverse reactions between the two groups,and analyzed the relationship be-tween urinary protein excretion rate(UAER)and serum NLR,CysC,and MCP-1.Results The total effective rate of the ob-servation group was 90.91%,higher than that of the control group,which was 67.27%(χ2/P=9.290/0.002).After 12 weeks of treatment,the levels of HbA 1c,FPG,and 2 h PGin the2 groups were lowerthan those before treatment,and the obser-vation group was lower than the control group(t/P=4.222/<0.001,6.064/<0.001,6.648/<0.001);Vdmin and Vsmax of IRA and MRA in the 2 groups were elevated compared with those before treatment,and the elevation was more obvious in the observation group than the control group(t/P=3.733/<0.001,6.800/0.001,2.598/0.011,2.043/0.043);the PI and RI of IRA and MRAof group 2 were reduced compared with those before treatment,and the reduction was more obvious in the observa-tion group than in the control group(t/P=4.194/<0.001,3.933/<0.001,3.265/0.001,6.171/<0.001);2 group's UAER,NLR,Cys-C,and MCP-1levels were reduced compared with those before treatment,and the reduction was more obvious in the observation group than the control group(t/P=14.534/<0.001,2.609/0.010,9.795/<0.001,6.618/<0.001);Pearson's analysis,NLR,Cys-C,and MCP-1 were positively correlated with UAER(r=0.513,20.764,0.685,all P<0.001).The difference in the in-cidence of adverse reactions between the 2 groups was not statistically significant when compared(χ2/P=0.910/0.340).Con-clusions Liraglutide combined with selegiline has good efficacy in the treatment of early T2DN,which can effectively im-prove renal hemodynamics,regulate the levels of NLR,Cys-C and MCP-1,and protect renal function.