Assessment of glomerular filtration rate based on alterations of serum brain-derived neurotrophic factor in type 2 diabetic subjects treated with amlodipine/benazepril or valsartan/hydrochlorothiazide.
BACKGROUND
Brain-derived neurotrophic factor (BDNF) is associated with sympathetic activation. However, the effects of BDNF on diabetic nephropathy are unknown. The aim of this study was to assess the estimated glomerular filtration rates (eGFRs) and changes in serum BDNF levels in type 2 diabetic subjects treated with antihypertensive medications.


METHODS
In this randomized, double-blind clinical trial, type 2 diabetic subjects with hypertension were assigned to either the benazepril/amlodipine or valsartan/hydrochlorothiazide treatment groups for a 16-week period. The post hoc analyses were based on increased or decreased serum BDNF levels.


RESULTS
Of the 153 enrolled subjects, the changes in eGFR were significantly and inversely correlated with those in BDNF in the 76 subjects treated with valsartan/hydrochlorothiazide (r = -0.264, P = 0.021) but not in the 77 subjects treated with benazepril/amlodipine (r = -0.025, P = 0.862). The 45 subjects with increased BDNF following valsartan/hydrochlorothiazide treatment exhibited a significantly reduced eGFR (-8.8 ± 14.9 mL/min/1.73 m(2); P < 0.001). Multivariate regression analysis revealed that increased serum BDNF represents an independent factor for reduced eGFR (95% confidence interval between -0.887 and -0.076, P = 0.020).


CONCLUSIONS
Increased serum BDNF is associated with reduced eGFR in type 2 diabetic subjects treated with valsartan/hydrochlorothiazide but not with amlodipine/benazepril.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan ; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan ; School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
I-Te
IT
Lee
Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan ; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan ; School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan.
Wayne Huey-Herng
WH
Sheu
Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan.
Yi-Jen
0000-0001-5318-9001
YJ
Hung
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan.
Jung-Fu
JF
Chen
Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei 10617, Taiwan.
Chih-Yuan
CY
Wang
Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Wen-Jane
WJ
Lee
D000368:Aged; D017311:Amlodipine / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001552:Benzazepines / Q000009:adverse effects; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D003928:Diabetic Nephropathies / Q000097:blood* / Q000139:chemically induced; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D000068756:Valsartan / Q000009:adverse effects
D000959:Antihypertensive Agents; D001552:Benzazepines; D019208:Brain-Derived Neurotrophic Factor; D006852:Hydrochlorothiazide; D017311:Amlodipine; D000068756:Valsartan; C044946:benazepril