Nephrol Dial Transplant (2001) 16: 90-93
© 2001 European Renal Association-European Dialysis and Transplant Association
Effect of losartan on TGF-ß1 and urinary albumin excretion in patients with type 2 diabetes mellitus and microalbuminuria
1 Diabetes Unit, Nephrology Department, 2 Hormonal Laboratory, Hospital Clinic Universitari, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona and 3 Nephrology Department, Hospital 12 de Octubre, Madrid, Spain
Background. The aim of the present study was to determine the effect of losartan on transforming growth factor-ß1 (TGF-ß1) plasma levels and urinary albumin excretion (UAE) in patients with type 2 diabetes mellitus, mild hypertension and microalbuminuria.
Methods. Fourteen patients (eight males, aged 55±6 years) with type 2 diabetes mellitus, mild arterial hypertension and microalbuminuria, participating in an open, uncontrolled, pilot study were included. Patients were treated for 8 weeks with losartan. TGF-ß1 plasma levels, UAE and 24-h blood pressure monitoring were determined at baseline and at 4 and 8 weeks.
Results. At 4 and 8 weeks of treatment, a reduction was observed in TGF-ß1 plasma levels (5.5±4.5 vs 2.0±0.6 and 2.6±1.0 ng/ml, P<0.005), UAE (96±65 vs 59±59 and 64±47 µg/min, P<0.01), 24-h systolic blood pressure (136±9 vs 129±9 and 130±10 mmHg, P<0.01) and 24-h diastolic blood pressure (77±9 vs 74±8 and 74±7 mmHg, P<0.03). Stratifying the patients by baseline TGF-ß1, seven had TGF-ß1 plasma values higher than normal controls. At 4 and 8 weeks, they showed a marked reduction in TGF-ß1 values (9.0±3.9 to 2.1±0.7 and 2.5±0.7 ng/ml, P<0.01) and UAE (106±83 to 49±42 and 38±26 µg/min, P<0.05), with good correlation between the percentage reduction of both parameters (r=0.83, P<0.01). The remaining seven patients, with normal baseline TGF-ß1 plasma levels, showed no change in TGF-ß1 plasma levels and UAE after treatment.
Conclusion. Treatment with losartan decreases TGF-ß1 plasma values and UAE in type 2 diabetes mellitus patients with high baseline TGF-ß1 levels, suggesting that TGF-ß1 may be a marker to detect patients who may particularly benefit from renin-angiotensin system blockade.
Keywords: hypertension; losartan; microalbuminuria; transforming growth factor-ß1; type 2 diabetes
Correspondence and offprint requests to: Dr E. Esmatjes, Diabetes Unit, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, Spain.
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