PDF(Pubmed)
Abstract：
The number of people living with chronic kidney disease (CKD) is growing as our global population continues to expand. With aging, diabetes, and cardiovascular disease being major harbingers of kidney disease, the number of people diagnosed with diabetic kidney disease (DKD) has grown concurrently. Poor clinical outcomes in DKD could be influenced by an array of factors-inadequate glycemic control, obesity, metabolic acidosis, anemia, cellular senescence, infection and inflammation, cognitive impairment, reduced physical exercise threshold, and, importantly, malnutrition contributing to protein-energy wasting, sarcopenia, and frailty. Amongst the various causes of malnutrition in DKD, the metabolic mechanisms of vitamin B (B1 (Thiamine), B2 (Riboflavin), B3 (Niacin/Nicotinamide), B5 (Pantothenic Acid), B6 (Pyridoxine), B8 (Biotin), B9 (Folate), and B12 (Cobalamin)) deficiency and its clinical impact has garnered greater scientific interest over the past decade. There remains extensive debate on the biochemical intricacies of vitamin B metabolic pathways and how their deficiencies may affect the development of CKD, diabetes, and subsequently DKD, and vice-versa. Our article provides a review of updated evidence on the biochemical and physiological properties of the vitamin B sub-forms in normal states, and how vitamin B deficiency and defects in their metabolic pathways may influence CKD/DKD pathophysiology, and in reverse how CKD/DKD progression may affect vitamin B metabolism. We hope our article increases awareness of vitamin B deficiency in DKD and the complex physiological associations that exist between vitamin B deficiency, diabetes, and CKD. Further research efforts are needed going forward to address the knowledge gaps on this topic.
摘要：
随着全球人口的不断扩大，患有慢性肾病（CKD）的人数正在增加。随着年龄的增长，糖尿病,心血管疾病是肾脏疾病的主要先兆，诊断为糖尿病肾病(DKD)的人数同时增加.DKD的不良临床结局可能受到一系列因素的影响-血糖控制不足，肥胖，代谢性酸中毒,贫血,细胞衰老,感染和炎症，认知障碍，降低体育锻炼阈值，and,重要的是,营养不良导致蛋白质能量消耗，少肌症,和脆弱。在DKD营养不良的各种原因中，维生素B（B1（硫胺素），B2（核黄素），B3（烟酸/烟酰胺），B5（泛酸），B6（吡哆醇），B8（生物素），B9（叶酸），和B12（钴胺））缺乏症及其临床影响在过去十年中引起了更大的科学兴趣。关于维生素B代谢途径的生化复杂性以及它们的缺乏如何影响CKD的发展，仍然存在广泛的争论。糖尿病,随后是DKD，反之亦然。我们的文章提供了关于正常状态下维生素B亚型的生化和生理特性的最新证据的综述，以及维生素B缺乏及其代谢途径的缺陷如何影响CKD/DKD的病理生理学，相反，CKD/DKD进展如何影响维生素B代谢。我们希望我们的文章能提高人们对DKD中维生素B缺乏以及维生素B缺乏之间存在的复杂生理关联的认识，糖尿病,CKD。需要进一步的研究努力来解决关于这一主题的知识差距。
