辅酶Q10对2型糖尿病造影剂诱发的急性肾损伤的影响:随机临床试验

Chonnam medical journal Pub Date : 2024-01-01 Epub Date: 2024-01-25 DOI:10.4068/cmj.2024.60.1.59
Ashkan Karbasi, Ali Abbasi, Abbas Mohagheghi, Jalal Poorolajal, Farzad Emami, Shirin Moradkhani, Iraj Khodadadi, Mahmoud Gholyaf, Heidar Tavilani
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摘要

造影剂诱发的急性肾损伤(CI-AKI)是注射造影剂后经常面临的挑战,随后会产生氧化应激。本研究旨在评估辅酶 Q10(Q10)作为线粒体靶向抗氧化剂对糖尿病患者 CI-AKI 的预防作用。118名糖尿病患者被随机分配到口服120毫克辅酶Q10(Q10组)或安慰剂(安慰剂组)的治疗组,从注射造影剂前24小时开始,连续治疗4天。在治疗前后评估了血尿素氮(BUN)、血清肌酐和尿肌酐、肾小球滤过率(eGFR)、尿丙二醛(UMDA)、尿总抗氧化能力(UTAC)以及尿线粒体与核DNA比率(mtDNA/nDNA比率)。Q10 组和安慰剂组的尿蛋白尿量、血清肌酐和尿肌酐水平以及尿显微镜评分(UMS)相似。治疗前,Q10 组的表皮生长因子受体降低(P=0.013),但治疗后没有降低。安慰剂组和 Q10 组的尿 mtDNA/nDNA 比值分别为 3.05±1.68 和 3.69±2.58,但治疗前(p=0.006)和治疗后(p=0.013),Q10 组的尿 mtDNA/nDNA 比值均较低(p=0.013)。
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The Effects of Coenzyme Q10 on Contrast-Induced Acute Kidney Injury in Type 2 Diabetes: A Randomized Clinical Trial.

Contrast-induced acute kidney injury (CI-AKI) is a frequent challenge following the injection of contrast media and its subsequent oxidative stress. The aim of the present study was to evaluate the preventive effects of coenzyme Q10 (Q10), as a mitochondrial-targeted antioxidant in CI-AKI in diabetic patients, who account for a large proportion of angiographic cases. A total of 118 diabetic patients were randomly assigned to receive 120 mg of oral coenzyme Q10 (Q10 group) or placebo (Placebo group) for four days, starting 24 hours before contrast media injection. Blood urea nitrogen (BUN), serum and urinary creatinine, estimated glomerular filtration rate (eGFR), urinary malondialdehyde (UMDA), urinary total antioxidant capacity (UTAC), and urinary mitochondrial to nuclearDNA ratios (mtDNA/nDNA ratio) were evaluated before and after the treatment period. Urine sediments were also evaluated to report the urine microscopy score (UMS).The levels of BUN, serum and urine creatinine, and UMS were similar in the Q10 and placebo groups. EGFR was lower in the Q10 group before the treatment (p=0.013) but not after. The urinary mtDNA/nDNA ratio was 3.05±1.68 and 3.69±2.58 in placebo and Q10 groups, but UTAC was found to be lower in Q10 both before (p=0.006) and after the treatment (p<0.001). The incidence of CI-AKI was 14.40% and the mtDNA/nNDA ratio was similar between CI-AKI and non-CI-AKI patients. In conclusion, Q10 treatment shows no favorable effect on prevention of CI-AKI or a urinary mtDNA/nDNA ratio among diabetic patients.

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