Urinary TGF-beta1 reduction related to a decrease of systolic blood pressure in patients with type 2 diabetes and clinical diabetic nephropathy.
With the aim to determine the influence of reducing systolic blood pressure in urinary TGF-beta1 of type 2 diabetes (DM2) with diabetic nephropathy (DN), 21 subjects with type 2 diabetes and proteinuria >500 mg/24 h were studied. Amlodipine and ramipril were added to their previous antihypertensive treatment for 12 weeks. Urinary TGF-beta1 (UTGF-beta1) was determined at 0, 4, 8 and 12 weeks. Plasma TGF-beta1 was determined at 0 and 12 weeks. Subjects whose mean systolic blood pressure (SBP) during treatment were under 140 mmHg were grouped as the better SBP controlled group (n = 11) and those with SBP equal to or greater than 140 mHg were grouped in a moderate SBP controlled group (n = 10). Compared to baseline, mean log UTGF-beta1 at 4, 8 and 12 weeks decreased (-0.22 +/- 0.15 pg/mg; p = 0.04) in better SBP controlled group but not in the moderate SBP controlled group (-0.12 +/- 0.08 pg/mg, p = 0.82). Mean SBP correlated with UTGF-beta1 (r = 0.458, p = 0.0357), and this effect was independent of HbA1c (p = 0.042). By controlling SBP in DM2 subjects with DN we might decrease UTGF-beta1. We propose that reduction of UTGF-beta1 is due to a decrease in renal TGF-beta1 production.
Bertoluci
Marcello Casaccia
MC
Departamento de Medicina Interna da Universidade Federal do Rio Grande do Sul/Hospital de Clínicas de Porto Alegre and Faculdade Federal de Ciências Médicas de Porto Alegre (FFFCMPA)/Hospital Santa Casa de Porto Alegre, Brazil.
Uebel
Deise
D
Schmidt
Alexandre
A
Thomazelli
Fulvio Clemo Santos
FC
Oliveira
Fábio Ramos
FR
Schmid
Helena
H
D017311:Amlodipine / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001262:Atenolol / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002216:Captopril / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000652:urine*; D003928:Diabetic Nephropathies / Q000097:blood* / Q000188:drug therapy / Q000652:urine*; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000178:diet therapy / Q000188:drug therapy / Q000652:urine; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011433:Propranolol / Q000627:therapeutic use; D017257:Ramipril / Q000627:therapeutic use; D053773:Transforming Growth Factor beta1 / Q000652:urine*
D017311:Amlodipine; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001262:Atenolol; D001786:Blood Glucose; D002216:Captopril; D003404:Creatinine; D004656:Enalapril; D006442:Glycated Hemoglobin; D006852:Hydrochlorothiazide; D011188:Potassium; D011433:Propranolol; D017257:Ramipril; D053773:Transforming Growth Factor beta1