Effect of pioglitazone on urinary liver-type fatty acid-binding protein concentrations in diabetes patients with microalbuminuria.
BACKGROUND
Urinary liver-type fatty acid-binding protein (L-FABP) is a useful marker for renal tubulointerstitial injury. Pioglitazone is reported to be effective in early diabetic nephropathy. The aim of the present study was to determine whether pioglitazone affects urinary L-FABP levels in diabetic nephropathy patients with microalbuminuria.


METHODS
Sixty-eight patients with type 2 diabetes and microalbuminuria were randomized to a 12-month treatment with pioglitazone (30 mg/d, n = 17), glibenclamide (5 mg/d, n = 18), voglibose (0.6 mg/d, n = 17), or nateglinide (270 mg/d, n = 16). Pre- and posttreatment urinary albumin excretion (UAE) and urinary L-FABP concentrations were compared between the four treatment groups and 40 age-matched healthy subjects.


RESULTS
Pretreatment UAE and urinary L-FABP levels differed little between the four groups. UAE and urinary L-FABP levels were significantly greater in the diabetes patients than in the healthy subjects (UAE: p < 0.001; L-FABP: p < 0.01). After 6 and 12 months, UAE and urinary L-FABP were significantly lower in the pioglitazone treatment group than in the other treatment groups (UAE: 6 months, p < 0.01 and 12 months, p < 0.001; L-FABP: 6 months, p < 0.05 and 12 months, p < 0.01).


CONCLUSIONS
Pioglitazone, but not glibenclamide, voglibose, or nateglinide, appears to be effective in reducing UAE and the urinary L-FABP level, suggesting that pioglitazone has a specific role in ameliorating both glomerular and tubulointerstitial lesions associated with early diabetic nephropathy.
Nakamura
Tsukasa
T
Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
Sugaya
Takeshi
T
Kawagoe
Yasuhiro
Y
Ueda
Yoshihiko
Y
Koide
Hikaru
H
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000517:prevention & control / Q000652:urine*; D003510:Cyclohexanes / Q000627:therapeutic use; D003925:Diabetic Angiopathies / Q000652:urine*; D050556:Fatty Acid-Binding Proteins / Q000652:urine*; D005260:Female; D005905:Glyburide / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007294:Inositol / Q000031:analogs & derivatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D000077715:Nateglinide; D010649:Phenylalanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*
D003510:Cyclohexanes; C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077715:Nateglinide; D010649:Phenylalanine; D007294:Inositol; C102817:voglibose; D005905:Glyburide; D000077205:Pioglitazone