Effect of renin-angiotensin-aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy
Effect of renin-angiotensin-aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy
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DOI：
10.1111/j.1440-1797.2009.01173.x
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发表时间：
2010-03-01
期刊：
影响因子：
2.5
通讯作者：
Yilmaz, Mahmut Ilker
中科院分区：
文献类型：
--
作者：
Eyileten, Tayfun;Sonmez, Alper;Yilmaz, Mahmut Ilker
目的：糖尿病肾病患者血浆内脂素水平升高，与蛋白尿和肾小球滤过率的严重程度平行。方法：选择肾小球滤过率（GFR）正常的糖尿病蛋白尿（>500 mg/d）患者32例，正常对照组33例。治疗2个月。结果：治疗前后患者血浆内脂素、高敏C反应蛋白（hsCRP）水平明显升高，内脂素、血流介导的舒张功能（FMD）明显降低（P均<0.001），血浆hsCRP水平明显升高（P均< 0.001），血浆内脂素水平明显降低（P均< 0.001）。内脂素水平与FMD、收缩压、舒张压、蛋白尿、eGFR、HOMA-IR和hsCRP显著相关。雷米普利治疗后血浆内脂素、蛋白尿、hsCRP、HOMA-IR均明显下降，FMD明显升高（P均<0.001）。结论：血浆内脂素水平与糖尿病肾病患者的内皮功能、炎症反应及蛋白尿严重程度有关。雷米普利治疗可使内脂素水平沿着显著降低，并改善糖尿病肾病的蛋白尿、内皮功能障碍和炎症状态。
Aim: Plasma visfatin levels are elevated in diabetic nephropathy in parallel to the severity of proteinuria and glomerular filtration rate. The aim of this study was to find out whether the renin-angiotensin-aldosterone system (RAAS) blockage has any effect on the plasma visfatin levels.Methods: Thirty-two patients with diabetic proteinuria (>500 mg/day) with a normal glomerular filtration rate (GFR) and 33 healthy subjects were enrolled. Patients were treated with ramipril 5 mg daily for 2 months. Proteinuria, GFR, high-sensitivity C-reactive protein (hsCRP), visfatin, flow-mediated dilatation (FMD) and homeostasis model assessment of insulin resistance (HOMA-IR) index measurements were performed both before and after the treatment.Results: The plasma visfatin, and hsCRP levels of the patients were significantly higher and the FMD was significantly lower (P < 0.001 for all). The visfatin levels were significantly correlated to FMD, systolic and diastolic blood pressures, proteinuria, eGFR, HOMA-IR and hsCRP. Ramipril treatment resulted in a significant decrease in plasma visfatin, proteinuria, hsCRP, HOMA-IR and increase in FMD (P < 0.001) in patients (P < 0.001 for all).Conclusion: The present study suggests that plasma visfatin levels are related to the endothelial functions, inflammation and the severity of proteinuria in diabetic nephropathy. Treatment with ramipril causes a significant decrease in visfatin levels along with the improvement of proteinuria, endothelial dysfunction and inflammatory state in diabetic nephropathy.