Objective: To determine the possible mechanism in diabetic nephropathy with normoalbuminuria and the effect of Bailing capsule on intervention. Method: Two hundred diabetes patients without micro albuminuria were selected and randomly divided into 2 groups

NDN group (n=100) and control group (n=100). Two groups were studied to compare the clinical data and laboratory results. Logistic regression analysis was used for the impacting factors of renal impairment. The NDN group was further divided into 2 groups:routine group (n=50) was treated with insulin.The Bailing capsule group (n=50) was treated with Bailing capsule combined with insulin. After 8 weeks

the clinical data and laboratory results in two groups were compared before and after treatment. Result: Normoalbuminuria diabetic nephropathy patients showed that the ankle-brachial index (ABI)

toe-brachial index (TBI) and glomerular filtration rate(eGFR) were lower than that of the control group [ABI (0.82±0.17) VS (1.07±0.51)

TBI (0.64±0.16) VS (0.99±0.23)

eGFR (49.5±6.5) VS(95.4±7.1) mL·min-1·(1.73 m2)-1] (P<0.05)

serum 8-isoprostaglandin F2α(8-iso-PGF2α) and carotid intima-media thickness (CIMT) were higher than that of the control group [8-iso-PGF2α (18.72±3.2) VS (8.21±1.9) μg·L-1

CIMT (1.13±0.19) VS (0.71±0.17)mm] (P<0.05). GFR was significantly positively correlated with ABI and TBI in patients with normoalbuminuria diabetic nephropathy (r=0.432

0.374

P<0.05). ABI

TBI and 8-iso-PGF2α were independent risky factors of renal impairment in patients with normoalbuminuria diabetic nephropathy (P<0.005

P<0.001

P<0.001). After treatment

the 8-iso-PGF2α in the Bailing capsule group was decreased more significantly than routine group [(9.34±2.8) VS (18.08±4.1) μg·L-1]. After treatment the ABI

TBI in the Bailing capsule group was increased more significantly than routine group [ABI (0.98±0.35) VS (0.81±0.35)

TBI (0.92±0.23) VS (0.62±0.22)] (P<0.05). Conclusion: The incidence of normoalbuminuria diabetic nephropathy may be associated with atherosclerosis and oxidative stress. The intervention with Bailing capsule can delay the development of normoalbuminuria diabetic nephropathy.