Архивъ внутренней медицины (Sep 2021)
The Effect of Combination Therapy with Melatonin on the Enzymes of Glutathione System and the Level of Transforming Growth Factor- β1 in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease
Abstract
Aim. The aim of the work was to assess the effect of combination therapy with melatonin on the clinical and biochemical parameters of chronic kidney disease (CKD) and type 2 diabetes mellitus (DM), the level of transforming growth factor-β1, lipid profile, activity of the glutathione antioxidant system enzymes and the activity of NADPH-generating enzymes in patients.Materials and methods. The study involved 60 people (19 men and 41 women, average age 65.6 ± 9.3 years) with chronic kidney disease associated with type 2 diabetes. The patients were divided into 2 groups. The first group of patients received basic treatment (n = 30, 8 men and 22 women, mean age 64.1 ± 7.9 years); the second group of participants (n = 30, 11 men and 19 women, mean age 69.0 ± 10.5 years) received 2 mg of melatonin in addition to the basic therapy. The control group consisted of 65 apparently healthy individuals (30 men and 35 women, average age 42.3±17.7 years) with normal indicators of general and biochemical blood tests. In the course of the work, the analysis of clinical and biochemical indicators and lipid profile in blood serum, the level of transforming growth factor-β1 by enzyme immunoassay, the activity of enzymes of the glutathione antioxidant system and NADPH-generating enzymes by the spectrophotometric method were carried out.Results. The use of melatonin additionally with basic treatment compared with standard therapy led to a decrease in proteinuria (p=0.010), hyperglycemia (p=0.019), urea concentration (p=0.043), glycated hemoglobin (p=0.045) and transforming growth factor-β1 levels (p=0.020) in patients with CKD. In addition, the use of this drug led to a changing of the lipid profile, and the activity of glutathione antioxidant system enzymes and NADPH-generating enzymes.Conclusion. The differences observed during the study were apparently caused by the action of melatonin, which has nephroprotective and hypoglycemic properties, the ability to neutralize reactive oxygen species and activate the antioxidant system functioning.
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