title: Sitagliptin reduces the urine albumin-to-creatinine ratio in type 2 diabetes through decreasing both blood pressure and estimated glomerular filtration rate.
abstract: BACKGROUND
  We investigated the change in the urine albumin-to-creatinine ratio (ACR) to examine the effect of sitagliptin on diabetic nephropathy.
  
  
  METHODS
  Sitagliptin at a dose of 50 mg was administered to 247 outpatients with type 2 diabetes. Data were collected on the patients' laboratory results (including the ACR), blood pressure, and body weight. Clinical data were compared before and after 3 months' administration of sitagliptin.
  
  
  RESULTS
  The ACR changed from 150.0 ± 538.6 mg/gCre to 148.3 ± 764.6 mg/gCre over 3 months. In the patients with micro- and macro-albuminuria, the ACR after 3 months significantly decreased compared with the baseline (P = 0.04 and P = 0.02, respectively). The subjects whose ACR decreased experienced significantly larger decreases over the 3-month period in blood pressure and estimated glomerular filtration rate (eGFR) than the other subjects. There was no significant correlation between change in ACR (ΔACR) and change in hemoglobin A1c (ΔHbA1c) during 3 months (r = 0.04, P = 0.59), but there was a significant correlation between change in ΔACR and change in systolic blood pressure (r = 0.16, P = 0.03). Multiple regression analysis revealed that the significant predictors for ΔACR were change in systolic blood pressure (β = 0.21, P = 0.016) and change in eGFR (β = 0.20, P = 0.024) over 3 months (r = 0.35, P = 0.04).
  
  
  CONCLUSIONS
  Sitagliptin reduces the ACR through decreasing both blood pressure and eGFR, with no correlation with a decrease in HbA1c over a 3-month period. These results may reflect the direct action of sitagliptin on the kidneys.
authors.affiliation: Department of Metabolism and Endocrinology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Kawasaki
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Hiura
authors.forename: Anna
authors.initials: A
authors.lastname: Tamai
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yakusiji
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Ikuno
authors.forename: Megumi
authors.initials: M
authors.lastname: Okada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ueno
authors.forename: Nagaaki
authors.initials: N
authors.lastname: Tanaka
authors.forename: Keiko
authors.initials: K
authors.lastname: Yamagami
authors.forename: Mariko
authors.initials: M
authors.lastname: Fukumoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hosoi
mesh_terms: D000419:Albuminuria / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects*; D003404:Creatinine / Q000652:urine*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011719:Pyrazines / Q000627:therapeutic use*; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D011719:Pyrazines; D000068900:Sitagliptin Phosphate; D014230:Triazoles
keywords: albumin-to-creatinine ratio; diabetic nephropathy; sitagliptin; 关键词：白蛋白/肌酐比值，糖尿病肾病，西格列汀