25 April 2019 : Clinical Research
Long-Term Intensive Lifestyle Intervention Promotes Improvement of Stage III Diabetic NephropathyLi Dong1BC, Jie Li1DE, Yu Lian2AB, Zu-xia Tang1DF, Zheng Zen1BD, Pan Yu3G*, Yang Li1AG
Med Sci Monit 2019; 25:3061-3068
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, biomarkers, Blood Glucose, Body Mass Index, Case-Control Studies, Cholesterol, HDL, Diabetes Mellitus, Glycated Hemoglobin A, Middle Aged, RNA-Binding Proteins, Risk Reduction Behavior, Transforming Growth Factor beta1
01 March 2023 : EditorialEditorial: Global Surveillance of Highly Pathogenic Avian Influenza Viruses in Poultry, Wild Birds, and Mammals to Prevent a Human Influenza Pandemic
Med Sci Monit 2023; 29:e939968
09 February 2023 : Clinical ResearchEvaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During ...
Med Sci Monit 2023; 29:e938892
19 January 2023 : Clinical ResearchDetermining the Impact of the COVID-19 Pandemic on Dental Care in the Serbian Adult Population: An Online Q...
Med Sci Monit 2023; 29:e939238
27 December 2022 : Clinical ResearchEffect of Physiotherapy to Correct Rounded Shoulder Posture in 30 Patients During the COVID-19 Pandemic in ...
Med Sci Monit 2022; 28:e938926
10 December 2022 : Clinical ResearchRetrospective Study to Identify Risk Factors for Severe Disease and Mortality Using the Modified Early Warn...
Med Sci Monit 2022; 28:e938647
24 Mar 2023 : Database AnalysisCauses of Death Following Gastric Cancer Diagnosis: A Population-Based Analysis
Med Sci Monit In Press; DOI: 10.12659/MSM.939848
22 Mar 2023 : Special reportOne Year On: Poland’s Public Health Initiatives and National Response to Millions of Refugees from Ukraine
Med Sci Monit In Press; DOI: 10.12659/MSM.940223
22 Mar 2023 : Clinical ResearchValue of IL-1β and IL-23 in Predicting 28-Day Mortality Due to Sepsis: A Retrospective Study
Med Sci Monit In Press; DOI: 10.12659/MSM.940163
21 Mar 2023 : Clinical ResearchEfficacy of Direct Anterior Approach Versus Posterior Lateral Approach for Total Hip Replacement in Patient...
Med Sci Monit In Press; DOI: 10.12659/MSM.939682
Most Viewed Current Articles
13 Nov 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit 2021; 27:e932788
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Jan 2022 : EditorialEditorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...
Med Sci Monit 2022; 28:e935952