25 April 2019 : Clinical Research
Long-Term Intensive Lifestyle Intervention Promotes Improvement of Stage III Diabetic Nephropathy
Li Dong1BC, Jie Li1DE, Yu Lian2AB, Zu-xia Tang1DF, Zheng Zen1BD, Pan Yu3G*, Yang Li1AGDOI: 10.12659/MSM.913512
Med Sci Monit 2019; 25:3061-3068
Abstract
BACKGROUND: Diabetic nephropathy (DN) is a potentially fatal complication of diabetes mellitus. While lifestyle changes can reduce diabetes risk, it is unclear whether improved lifestyle can slow or reverse DN progression. This study evaluated whether an intensive lifestyle intervention (IL-I) targeting weight loss and inflammation through increased physical activity and reduced caloric intake can delay DN progression.
MATERIAL AND METHODS: Patients were randomly divided into 2 groups. Both groups received diet and exercise guidelines, but one (IL-I) received more frequent external support than the other (control). We compared markers of metabolic and cardiovascular health, redox status, inflammation, and renal function between groups at 3 and 6 months. Metabolic and cardiovascular metrics included BMI, blood pressure, blood glycosylated hemoglobin (HbA1c), and serum HDL-cholesterol. Redox status was evaluated by serum superoxide dismutase (SOD) and the lipid oxidation product malondialdehyde (MDA), while inflammation was assessed by serum concentrations of IL-6 and TNF-α. Renal function was assessed by urine/serum 8-OHdG, albumin: creatinine ratio (ACR), and the renal fibrosis marker TGF-β1.
RESULTS: Both groups demonstrated initial BMI reduction, lower HbA1c, and higher HDL-cholesterol, but changes were significantly larger in the IL-I group at 6 months. Blood pressure at 6 months was reduced only in the IL-I group. The IL-I group also achieved a greater sustained SOD increase and MDA reduction. Finally, only the IL-I group demonstrated significant reductions in urine ACR, serum/urine 8-OHdG, and plasma TGF-β1. These indicators deteriorated after IL-I was stopped.
CONCLUSIONS: Lifestyle changes including exercise and diet can delay renal damage and promote improvement from DN.
Keywords: Caloric Restriction, Fibrosis, Life Style, Blood Glucose, Body Mass Index, Case-Control Studies, Cholesterol, HDL, Diabetes Mellitus, Glycated Hemoglobin A, RNA-Binding Proteins, Risk Reduction Behavior, Transforming Growth Factor beta1
Editorial
01 March 2024 : Editorial
Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and Transfusion-Dependent β-ThalassemiaDOI: 10.12659/MSM.944204
Med Sci Monit 2024; 30:e944204
In Press
08 Feb 2024 : Clinical Research
Serum Selenium Concentration as a Potential Diagnostic Marker for Early-Stage Colorectal Cancer: A Comparat...Med Sci Monit In Press; DOI: 10.12659/MSM.942882
09 Feb 2024 : Clinical Research
Factors Influencing the Occurrence of Intraoperative Hypothermia in Patients Undergoing General Anesthesia ...Med Sci Monit In Press; DOI: 10.12659/MSM.943463
13 Feb 2024 : Clinical Research
A Retrospective Study to Compare the Glasgow Coma Score, Pediatric Trauma Score, and Injury Severity Score ...Med Sci Monit In Press; DOI: 10.12659/MSM.943501
16 Feb 2024 : Clinical Research
Etiology, Clinical Presentation, and Outcomes of Bacterial Meningitis in Adult Patients: A Retrospective St...Med Sci Monit In Press; DOI: 10.12659/MSM.942904
Most Viewed Current Articles
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952