Effect of renin-angiotensin-aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy.

Tayfun Eyileten, Alper Sonmez, Mutlu Saglam, Erdinc Cakir, Kayser Caglar, Yusuf Oguz, Abdulgaffar Vural, Mujdat Yenicesu, Mahmut Ilker Yilmaz
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引用次数: 21

Abstract

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.

肾素-血管紧张素-醛固酮系统(RAAS)阻断对糖尿病肾病患者胰脂素水平的影响。
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。本研究旨在探讨肾素-血管紧张素-醛固酮系统(RAAS)阻塞是否对血浆内脂素水平有影响。方法:选取肾小球滤过率(GFR)正常的糖尿病蛋白尿(>500 mg/d)患者32例和健康对照者33例。患者每日服用雷米普利5mg,持续2个月。在治疗前后分别测量蛋白尿、GFR、高敏c反应蛋白(hsCRP)、visfatin、血流介导扩张(FMD)和胰岛素抵抗(HOMA-IR)指数的稳态模型评估。结果:患者血浆visfatin、hsCRP水平显著升高,FMD水平显著降低(P均< 0.001)。visfatin水平与FMD、收缩压和舒张压、蛋白尿、eGFR、HOMA-IR和hsCRP显著相关。雷米普利治疗导致患者血浆内脂素、蛋白尿、hsCRP、HOMA-IR显著降低(P < 0.001), FMD升高(所有患者均P < 0.001)。结论:血浆内脂素水平与糖尿病肾病的内皮功能、炎症及蛋白尿严重程度有关。雷米普利治疗可显著降低胰脂素水平,同时改善蛋白尿、内皮功能障碍和糖尿病肾病的炎症状态。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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