TGFB1 and diabetic kidney disease: There are also other mechanisms by which butyrate protects against DKD, including: Nrf2 activation [71], amelioration of insulin resistance via modulation of intestinal permeability and mucin expression [65], inhibition of pyroptosis and apoptosis [72], mediation of the miR-7α-5p/p311/TGF-β pathway [73], and activation of AMPK/Sirt1/PGC-1α signaling pathway [74,75].