Assessment of urinary microalbumin and oxygenation in diabetic patients using blood oxygenation level-dependent MRI

doi:10.3969/j.issn.1006-7795.2021.01.021

Abstract

Abstract: Objective To explore the relationship between the ratio of urine albumin to creatinine(ACR) and renal oxygenation in patients with type 2 diabetes by blood oxygen level-dependent magnetic resonance imaging(BOLD MRI). Methods Totally 44 patients with type 2 diabetes and 14 healthy volunteers were recruited. Diabetic patients were divided into ACR normal diabetic group, early diabetic nephropathy group and clinical diabetic nephropathy group based on ACR. Bilateral renal cortical R2^*(CR2^*) and medullary R2^*(MR2^*) values were extracted and quantified on BOLD MRI. CR2^* and MR2^* were compared among the groups separately. The relationships were analyzed between R2^* values and clinical index of renal function. Results Compared with controls, MR2^* in ACR normal diabetic group(P=0.015) and clinical diabetic nephropathy group(P=0.023) were significantly increased. MR2^* in the early diabetic nephropathy group was higher than that in normal control group, but the difference was not statistically significant. CR2^* in each diabetes group was higher than that in the normal control group, but there was no statistical difference. The positive correlation was found between MR2^* and ACR(r=0.409, P=0.006). Conclusion BOLD MRI could non-invasively evaluate the renal oxygenation level in different stages of ACR in diabetic patients and monitor functional hypoxia changes in renal medulla in early diabetic patients.

Key words: type 2 diabetes, kidney, blood oxygen level dependent, magnetic resonance imaging

CLC Number:

Zheng Shuangshuang, Gao Zhiyuan, Song Shuangshuang, He Yueming, Lu Jie. Assessment of urinary microalbumin and oxygenation in diabetic patients using blood oxygenation level-dependent MRI[J]. Journal of Capital Medical University, 2021, 42(1): 125-130.

0
/ / Recommend

Add to citation manager EndNote|Reference Manager|ProCite|BibTeX|RefWorks

URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.01.021

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I1/125

References

[1] Ma R C W. Epidemiology of diabetes and diabetic complications in China [J]. Diabetologia, 2018, 61(6):1249-1260.
[2] Warren A M, Knudsen S T, Cooper M E. Diabetic nephropathy: an insight into molecular mechanisms and emerging therapies[J]. Expert Opin Ther Targets, 2019, 23(1):1-13.
[3] Zhang L, Long J, Jiang W, et al. Trends in chronic kidney disease in China [J]. N Engl J Med, 2016, 375(9): 905-906.
[4] 郑爽爽,何悦明. 糖尿病的肾脏磁共振研究进展[J]. 北京医学, 2017, 39(1): 87-89.
[5] Niendorf T, Pohlmann A, Arakelyan K, et al. How bold is blood oxygenation level-dependent (BOLD) magnetic resonance imaging of the kidney? Opportunities, challenges and future directions [J]. Acta Physiol (Oxf), 2015,213(1):19-38.
[6] Jia W, Weng J, Zhu D, et al. Standards of medical care for type 2 diabetes in China 2019 [J]. Diabetes Metab Res Rev, 2019, 35(6): e3158.
[7] 郭兰根. 糖尿病肾病的临床表现及诊断标准 [J]. 中国社区医师, 2010(32): 5.
[8] Hall M E, Jordan J H, Juncos L A, et al. BOLD magnetic resonance imaging in nephrology [J]. Int J Nephrol Renovasc Dis, 2018, 11:103-112.
[9] 周江燕,何悦明,尚润润,等. BOLD-MRI评价2型糖尿病患者降血糖治疗前后肾组织氧合状况 [J]. 中国医学影像技术, 2019, 35(2): 76-80.
[10]Hansell P, Welch W J, Blantz R C, et al. Determinants of kidneyoxygen consumption and their relationship to tissue oxygen tension in diabetes and hypertension [J]. Clin Exp Pharmacol Physiol, 2013, 40(2): 123-137.
[11]Ries M, Basseau F, Tyndal B, et al. Renal diffusion and BOLD MRI in experimental diabetic nephropathy [J]. J Magn Reson Imaging, 2003, 17(1):104-113.
[12]Prasad P V, Edelman R R, Epstein F H. Noninvasive evaluation of intrarenal oxygenation with BOLD MRI [J]. Circulation, 1996, 94(12): 3271-3275.
[13]Palm F. Intrarenal oxygen in diabetes and a possible link to diabetic nephropathy [J]. Clin Exp Pharmacol Physiol, 2006, 33(10): 997-1001.
[14]Magri C J, Fava S. The role of tubular injury in diabetic nephropathy [J]. Eur J Intern Med, 2009, 20(6):551-555.
[15]Pollock J S, Carmines P K. Diabetic nephropathy: nitric oxide and renal medullary hypoxia [J]. Am J Physiol Renal Physiol, 2008, 294(1): F28-29.
[16]Wang Q, Guo C, Zhang L, et al. BOLD MRI to evaluate early development of renal injury in a rat model of diabetes [J]. J Int Med Res, 2018, 46(4): 1391-1403.
[17]Yin W, Liu F, Li X, et al. Noninvasive evaluation of renal oxygenation in diabetic nephropathy by BOLD-MRI [J]. Eur J Radiol, 2012, 81(7): 1426-1431.
[18]蒋振兴,王毓,丁玖乐,等. 血氧水平依赖MRI评估糖尿病肾病肾功能损伤的研究 [J]. 磁共振成像, 2015, 6(7): 52-56.
[19]Wang Z J, Kumar R, Banerjee S, et al. Blood oxygen level-dependent (BOLD) MRI of diabetic nephropathy: preliminary experience [J]. J Magn Reson Imaging, 2011, 33(3): 655-660.
[20]Siddiqi L, Hoogduin H, Visser F, et al. Inhibition of the renin-angiotensin system affects kidney tissue oxygenation evaluated by magnetic resonance imaging in patients with chronic kidney disease [J]. J Clin Hypertens, 2014, 16(3): 214-218.
[21]Hall M E, Rocco M V, Morgan T M, et al. Beta-blocker use is associated with higher renal tissue oxygenation in hypertensive patients suspected of renal artery stenosis [J]. Cardiorenal Med, 2016, 6(4): 261-268.
[22]李露露,蒲实,范秋灵,等.糖尿病肾病患者循环miRNA表达谱的分析[J].中国医科大学学报,2019,48(8):694-698,708.
[23]马晓华,周亚男,王荣荣,等.持续低效缓慢血液透析治疗终末期糖尿病肾病临床观察[J].解放军医药杂志,2019,31(4):57-59.
[24]张瑞,肖文波,汪启东,等. BOLD MRI评价原发性肾病综合征的肾内氧代谢状态 [J]. 中国医学影像技术, 2017, 33(9): 1388-1391.
[25]Inoue T, Kozawa E, Okada H, et al. Noninvasive evaluation of kidney hypoxia and fibrosis using magnetic resonance imaging [J]. J Am Soc Nephrol, 2011, 22(8): 1429-1434.