Long-Term Intensive Lifestyle Intervention Promotes Improvement of Stage III Diabetic Nephropathy

Figures

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  Figure 1. Effect of long-term intensive lifestyle intervention (IL-I) on metabolic health in diabetic nephropathy (DN) patients. (A–C) Compared to control intervention, IL-I produced a larger and more sustained (A) decrease in BMI (Pa, Pb, and Pd <0.05; Pc <0.01; Pab >0.05; Pcd <0.05), (B) increase in HDL-cholesterol (Pa and Pb <0.05; Pc <0.01; Pab and Pd >0.05; Pcd <0.05), and (C) reduction in HbA1c (Pa, Pb, and Pd >0.05; Pc <0.01, Pab >0.05; Pcd <0.05). (D) The 2 groups both demonstrated a downward trend in blood glucose that did not reach statistical significance (Pa, Pb, Pc, Pd, Pab, and Pcd >0.05). Pa, 3 months vs. baseline in the IL-I group; Pb, 3 months vs. baseline in the control group; Pab, IL-I vs. control group at 3 months; Pc, 6 months vs. baseline in the IL-I group; Pd, 6 months vs. baseline in the control group; Pcd, IL-I vs. control group at 6 months.

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  Figure 2. Effects of IL-I on renal function and blood pressure. (A, B) IL-I reduces (A) systolic blood pressure (Pa, Pb, and Pd >0.05; Pc <0.01; Pab >0.05; Pcd >0.05) and diastolic blood pressure at 6 months (Pa, Pb, and Pd >0.05; Pc <0.01; Pab >0.05; Pcd >0.05). (C, D) There were no significant changes in creatinine and blood urea nitrogen at 3 and 6 months (Pa, Pb, Pc, Pd, Pab, and Pcd >0.05).

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  Figure 3. Long-term intensive lifestyle intervention enhances antioxidant capacity and reduces inflammation in DN patients. (A, B) Both IL-I and control groups exhibited increased SOD and reduced MDA at 3 and 6 months, but the increase was greater and more sustained in the IL-I group (Pa and Pb <0.05; Pc <0.01; Pab and Pd >0.05; Pcd <0.05). (B) Both groups also demonstrated reduced MDA at 6 months, but the change was greater in the IL-I group (Pa and Pb <0.05, Pc <0.01, Pd and Pab >0.05, Pcd <0.01). (C) Both groups showed reduced serum IL-6 at 3 and 6 months (Pa, Pb, and Pd <0.05; Pc <0.01; Pab >0.05; Pcd <0.05). (D) Both groups exhibited a downward trend in plasma TNF-α, but the difference from baseline did not reach statistical significance (Pa, Pb, Pc, Pd, Pab, and Pcd >0.05).

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  Figure 4. Long-term intensive lifestyle intervention improves renal function in diabetic nephropathy. (A, B) IL-I reduced both plasma (A) and 24-h urine (B) 8-OHdG (in A: Pa, Pb, and Pd <0.05; Pc <0.01; Pab and Pcd >0.05; in B: Pa, Pb, and Pd <0.05; Pc <0.01; Pab and Pcd >0.05). (C) Both IL-I and control groups demonstrated reduced 24-h urine ACR at 3 and 6 months, but the decrease was larger in the IL-I group (Pa, Pb, and Pab <0.05; Pc <0.01; Pab >0.05; Pcd <0.05). (D) IL-I also induced a more sustained reduction in TGF-β1 (Pa, Pb, and Pd >0.05; Pc <0.05; Pab >0.05; Pcd >0.05).