Effect of red wine on urinary protein, 8-hydroxydeoxyguanosine, and liver-type fatty acid–binding protein excretion in patients with diabetic nephropathy
Introduction
Oxidative stress is a central pathogenic mechanism underlying ischemic heart disease, atherosclerosis, and other chronic diseases [1]. The kidney is particularly vulnerable to damage caused by reactive oxygen species, probably because of the abundance of polyunsaturated fatty acids contained in renal lipids [2]. Reactive oxygen species are involved in the pathogenesis of glomerulosclerosis and tubulointerstitial fibrosis [2]. Epidemiologic studies have suggested beneficial effects of dietary polyphenols in reducing the risk of chronic diseases by reducing oxidative stress [3]. The beneficial effects of red wine polyphenols include prevention and/or attenuation of myocardial fibrosis, reduction in aortic wall thickening, and improvement in vascular function [4].
Diabetic nephropathy is a serious microvascular complication of diabetes and one of the main causes of end-stage renal disease. Many studies have revealed that increased oxidative stress is a major pathophysiologic mechanism underlying development of diabetic nephropathy. Treatment with a polyphenolic phytoalexin present in red wine significantly attenuated renal dysfunction and oxidative stress in diabetic rats [5]. Consumption of a moderate amount of red wine may have beneficial effects toward prevention of cardiovascular disease in diabetes patients [6]. In healthy persons, red wine has more antioxidant activity than white wine by virtue of its higher content of polyphenol [7]. However, little is known about the effect of white wine on renal function.
Liver-type fatty acid–binding protein (L-FABP) of 14.4 kd is expressed in proximal tubules of the human kidney [8]. Various pathophysiologic stresses on the proximal tubules such as significant proteinuria induce up-regulation of human L-FABP gene expression, resulting in increased urinary L-FABP excretion [8]. Urinary L-FABP levels reflect the clinical progression of chronic kidney disease. Urinary 8-hydroxydeoxyguanosine (8-OHdG) has been reported to serve as a sensitive biomarker of oxidative DNA damage [9], and its excretion is significantly correlated with the severity of tubulointerstitial lesions in patients with diabetic nephropathy [10]. The aim of the present study was to determine whether consumption of red wine or white wine affects urinary protein, 8-OHdG, and L-FABP excretion in type 2 diabetic nephropathy patients.
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Subjects and methods
Thirty-six patients with type 2 diabetic nephropathy (23 men and 13 women; age, 55 ± 11 years) were enrolled in the study. Diagnosis was based on clinical symptoms including chronic diabetes, increased urinary albumin excretion and retinopathy, laboratory data, or histologic findings according to the Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus [11]. Diabetic nephropathy was defined as at least 2 of 3 measurements of the albumin-creatinine ratio done
Results
There were no adverse effects including hypoglycemia during 6 months in all subjects. Clinical and laboratory baseline data of each group are shown in Table 1. After 6 months, the intake of fruit, vegetables, fish, meat, and polyunsaturated fatty acids was similar in the 3 groups (statistically not significant). We found a similar intake of total calories between the 3 groups (A, 1660 ± 140 kcal/d; B, 1640 ± 120 kcal/d; C, 1680 ± 130 kcal/d) (statistically not significant). There were no
Discussion
In the present study, we first observed that red, but not white, wine reduced urinary protein, urinary 8-OHdG, and urinary L-FABP levels in patients with diabetic nephropathy. Previous studies of tubulointerstitial injury as well as glomerular injury in diabetes may provide additional insight into the pathogenesis of diabetic nephropathy and lead to the identification of targets for therapeutic intervention [16]. We reported previously that urinary L-FABP appears to be associated with the
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The flavonoid rutin improves kidney and heart structure and function in an adenine-induced rat model of chronic kidney disease
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2013, Canadian Journal of DiabetesCitation Excerpt :Lorsqu'il est consommé avec des aliments, l'alcool ne cause ni hyperglycémie ni hypoglycémie (164). Chez les personnes atteintes de diabète de type 2, la consommation quotidienne modérée de vin rouge pendant 12 mois inverse le stress oxydatif et l’inflammation associés à l’infarctus du myocarde (165); chez les personnes atteintes d’une néphropathie, celle-ci exerce des effets rénoprotecteurs et hypotensifs après 6 mois; ces effets n’ont pas été observés avec le vin blanc (166). Par contre, plus la consommation d’alcool augmente, plus l’acuité visuelle décline mais sans que la rétinopathie ne s’aggrave (167).
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Urinary 8-oxo-7,8-dihydro-2′-deoxyguanosine as a biomarker in type 2 diabetes
2011, Free Radical Biology and MedicineCitation Excerpt :Only a few studies have been performed to assess the effect of lifestyle intervention on 8-oxodG excretion in type 2 diabetes patients. Nojima et al. found that 12 months of moderate-intensity aerobic exercise reduced 8-oxodG excretion significantly [41], and Nakamura et al. reported that 4 oz red wine daily for 6 months reduced 8-oxodG in type 2 diabetes patients with nephropathy [42]. Hinokio et al. found that the incidence of macroalbuminuria was increased in type 2 diabetes patients with higher excretion of 8-oxodG in urine compared with patients with moderate or lower excretion of 8-oxodG (P < 0.0001), and multivariate logistic regression analysis suggested that urinary 8-oxodG was the strongest predictor of nephropathy among several known risk factors [31].