二甲双胍治疗糖尿病肾病的研究进展2023

体辅助蛋白1(ATP6AP1)形成复合物，通过与AMPK激活的溶酶体感(TGF-β1)/激活素受体样激酶1(ALK1)。脉血乳酸水平>5.0mmol/L(参考值为0.5~2.2mm或血尿).可行UACR检测，在3~6个月内连续检测UACR,其中至少有2次出现二甲双胍治疗DN的分子机制见图1,包括：提高Klotho蛋白水平改善DN、通过促进AMPK介导的通路保护肾脏功能、通过抑制NF-KB介导的通路保护肾脏功能、通过抑制AGEs形成保护肾脏功能、通过调控微小sB.WwabmPam-Mur1Mdrdnsekasnsfetfeminfeeefedaesemdepstp二甲双胍作为主要治疗药物之一，通过调节Klotho帕霉素(mTOR)是一种丝/苏氨酸蛋白激酶，参与生物合介导过程。高糖可下调klotho表达，激活mTOR信号通路，加重p38MAPK可促进细胞增殖，进一步研究表明二甲双胍可阻断Klo赖性TGF-β1/p38丝裂原活化蛋白激酶(MAPK)通路阻止肾脏纤维化，[1]WUYL,DINGYP,TANAKAY,etal.Riskfactorscontriprevention[J].IntJMedSci,2014,11(11):1185-1200.aspotentialinterventiodiabetes:clinicalrelevance,mechanismsandfuturedirections[J].DiabetesMetabSyndr,2017,11(4):291-296.2021,138:111454.ofmetforminaction[J].EndocrRev,202Rev,2021,40(3):865-878.[9]HANYC,TANGSQ,LIUYT,perspective[J].IntJMolSci,2020mellitus[J].NatRevTranslMed,2023,21(1):403.metabolicreprogramminginpol2022,11:e74713.thenaturalhistoryoffunction[J].JNephrol,2020,33(1):9-35.Nephrol,2021,34(4):1127-1135.whenshouldwefearlacticacidosis?[J].IntJMolSci,withdiabetes[J].Cureus,2019,11(5):e47W,etal.Metformin-associatedlactice0273678.chronickidneydisease:ar[J].EndocrinolDiabetesM2018,9(9):179-190.RevNephrol,2021,17(11):740-750.disease[J].FrontImmunol,2021,12:603416.MetabolomicsasatoStemCellResTher,201ofmetformin[J].JMedSyst,2019,43(hyperglycemia:itslevelsandeffectson22(15):7867.amelioratesdiabetickidneydiseasebytargetinsignaling[J].KidneyInt,2022,102(3):5062019,18(6/7):696-707.hyperglycemia:itslevelsandeffectsonfibr22(15):7867.ofmetformin[J].JMedSyst,2019,43(8):266.2diabetesmellwithmetforminamelio2021,281:113548.ofmetformin[J].Diabetologia,2017,60(9):1577-1585.AMPK/SIRT1-FoxO1pathway[J].Moldiabeticnephropathy[J].JMol44(4):354-377.activationviatheNF-KB/TNF-ap[47]ZHANGL,NIUJS,ZHANGXM,etal[48]KANGZF,ZENGJW,ZHANGT,etal.Hyperglycem[49]PATIALV,KATOCHS,CHHIMWALJ,etal.Tinosporacordifoliainjuryindiabetickidneymitigateddiabeticpepathways[J].BiomedPharmacother,2022,145:112395.[51]TANGD,HEWJ,ZHANGindb/dbmice[J].Phytomedicine,2022,95:153777. (AGEs)-RAGE-inducedproximRes,2012,65(3):297-302.科大学学报，2015,5(6):898-902.[55]XUJ,XIANGP,LIU