title: Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease.
abstract: OBJECTIVE
  Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD.
  
  
  METHODS
  A double blind, randomized, placebo-controlled trial was conducted in 60 patients with T2DM and stage 3 or 4 CKD. Paricalcitol 1 mcg or placebo was administered orally once daily for three months. Brachial artery flow mediated dilatation (FMD), nitroglycerine mediated dilation (NMD), and plasma concentrations of inflammatory cytokines, tumor necrosis factor -α and interleukin-6, highly-sensitive C-reactive protein; endothelial surface proteins, intercellular adhesion molecule -1 and monocyte chemo attractant protein-1, and plasma glucose, insulin, free fatty acids, and urinary isoprostane were measured at baseline and end of three months.
  
  
  RESULTS
  27 patients in the paricalcitol group and 28 patients in the control group completed the study, though analysis of FMD at both time points was possible in 23 patients in each group. There was no significant difference in the change in FMD, NMD or the biomarkers examined after paricalcitol or placebo treatment.
  
  
  CONCLUSIONS
  Treatment with paricalcitol at this dose and duration did not affect brachial artery FMD or biomarkers of inflammation and oxidative stress. The lack of significance may be due to the fact that the study patients had advanced CKD and that effects of paricalcitol are not additive to the effects of glycemic, lipid and anti-hypertensive therapies.
authors: Tulane University Health Sciences Center, New Orleans, LA; Southeast Louisiana Veterans Health Care Systems, New Orleans, LA. Electronic address: tthethi@tulane.edu.
authors: Tina K
authors: TK
authors: Thethi
authors: Joslin Diabetes Center, Boston, MA.
authors: Muhammad A
authors: MA
authors: Bajwa
authors: Diabetes-Endocrinology Center of Western NY, Buffalo, NY.
authors: Husam
authors: H
authors: Ghanim
authors: Scott & White Clinic, Temple, TX.
authors: Chanhee
authors: C
authors: Jo
authors: Scott & White Clinic, Temple, TX.
authors: Monica
authors: M
authors: Weir
authors: Joslin Diabetes Center, Boston, MA; Harvard Medical School, Boston, MA.
authors: Allison B
authors: AB
authors: Goldfine
authors: Emory University, Atlanta, GA.
authors: Guillermo
authors: G
authors: Umpierrez
authors: University of Nebraska, Omaha, NB.
authors: Cyrus
authors: C
authors: Desouza
authors: Diabetes-Endocrinology Center of Western NY, Buffalo, NY.
authors: Paresh
authors: P
authors: Dandona
authors: Scott & White Clinic, Temple, TX.
authors: Ying
authors: Y
authors: Fang-Hollingsworth
authors: Scott & White Clinic, Temple, TX.
authors: Vasudevan
authors: V
authors: Raghavan
authors: Tulane University Health Sciences Center, New Orleans, LA; Southeast Louisiana Veterans Health Care Systems, New Orleans, LA.
authors: Vivian A
authors: VA
authors: Fonseca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D004872:Ergocalciferols / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D010919:Placebos; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D004872:Ergocalciferols; D007328:Insulin; D010919:Placebos; C084656:paricalcitol; D002097:C-Reactive Protein
keywords: Chronic kidney disease; Diabetes mellitus; Endothelial dysfunction; Inflammation; Paricalcitol
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