Effect of insulin-unstimulated diabetic therapy with miglitol on serum cystatin C level and its clinical significance.
The serum cystatin C level is thought to provide a more accurate estimate of renal function in diabetic subjects than creatinine-based methods. This study was designed to compare miglitol and miglitinide, on cystatin C levels. Forty patients with type 2 diabetes were randomly assigned to receive 150 mg/day miglitol or 30 mg/day mitiglinide. The serum cystatin C level was measured in 36 patients (19 in the miglitol group and 17 in the mitiglinide group) undergoing meal tolerance testing. High sensitivity C reactive protein (hsCRP) was also assessed. After 3 months of therapy, the cystatin C level did not change but the log-transformed hsCRP value decreased (3.03+/-0.32 to 2.83+/-0.34log[microg/L], P<0.05) in the miglitol group, whereas in the mitiglinide group the cystatin C level increased (0.75+/-0.18 to 0.78+/-0.20mg/L, P<0.05) but the hsCRP value did not change. After 3 months, the levels of cystatin C and hsCRP were each correlated with the postprandial insulin level in the meal tolerance test in all patients. These results suggest that postprandial insulin secretion might increase cystatin C and that insulin-unstimulated miglitol therapy might suppress an increase in cystatin C accompanied by an anti-inflammatory effect in diabetic patients.
Yokoyama
Hiroki
H
Department of Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Japan.
Inoue
Teruo
T
Node
Koichi
K
D017485:1-Deoxynojirimycin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D001549:Benzamides / Q000627:therapeutic use*; D055316:Cystatin C / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D001549:Benzamides; D055316:Cystatin C; D007004:Hypoglycemic Agents; D007328:Insulin; C045621:miglitol; D017485:1-Deoxynojirimycin; C030516:meglitinide