Comparative effects of pioglitazone, glibenclamide, and voglibose on urinary endothelin-1 and albumin excretion in diabetes patients.

Abstract

Urinary endothelin (ET)-1 excretion is present in non-insulin dependent diabetes (NIDDM) patients with microalbuminuria, and an increase in circulating ET-1 precedes the microalbuminuric phase of renal injury related to diabetes. The aim of the present study was to determine whether various drugs alter urinary ET-1 levels and urinary albumin excretion (UAE) in NIDDM patients with microalbuminuria. Forty-five NIDDM patients with microalbuminuria were randomly assigned to three groups: those treated with pioglitazone at 30 mg/day (n=15), those treated with glibenclamide at 5 mg/day (n=15), and those treated with voglibose at 0.6 mg/day (n=15). Patients received these drugs for 3 months. UAE, urinary ET-1, and plasma ET-1 levels were measured in these patients before and after treatment. Before treatment, UAE, urinary ET-1, and plasma ET-1 levels differed little among the three groups. UAE in the 45 NIDDM patients (156.2+/-42.8 microg/min) was greater than that in 30 healthy controls (8.2+/-2.6 microg/min) (P<.001). Urinary ET-1 levels in the NIDDM patients (8.7+/-1.3 ng/g urinary creatinine (UC)) were significantly higher than that in the controls (2.4+/-0.2 ng/g UC) (P<.01). Plasma ET-1 levels, however, in the NIDDM patients (1.3+/-0.4 pg/ml) did not differ significantly from the levels in healthy controls (1.0+/-0.6 pg/ml). Pioglitazone but no glibenclamide or voglibose reduced UAE from 142.8+/-42.2 to 48. 4+/-18.2 microg/min (P<.01) and urinary ET-1 levels from 8.6+/-1.3 to 3.4+/-0.5 ng/g UC (P<.01). These data suggest pioglitazone to be effective in reducing UAE and urinary ET-1 concentrations in NIDDM patients with microalbuminuria.

• Authors: T Nakamura, C Ushiyama, N Shimada, K Hayashi, I Ebihara, H Koide
• Journal: Journal of diabetes and its complications (J Diabetes Complications) 2000 Sep-Oct Vol. 14 Issue 5 Pg. 250-4 ISSN: 1056-8727 [Print] United States
• PMID: 11113686 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Endothelin-1
• Enzyme Inhibitors
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Thiazoles
• Thiazolidinediones
• Inositol
• voglibose
• Glyburide
• Pioglitazone

Topics

• Albuminuria
• Blood Pressure (drug effects)
• Diabetes Mellitus, Type 2 (drug therapy, physiopathology, urine)
• Endothelin-1 (urine)
• Enzyme Inhibitors (pharmacology, therapeutic use)
• Female
• Glyburide (pharmacology, therapeutic use)
• Glycated Hemoglobin (metabolism)
• Humans
• Hypoglycemic Agents (pharmacology, therapeutic use)
• Inositol (analogs & derivatives, pharmacology, therapeutic use)
• Male
• Middle Aged
• Pioglitazone
• Reference Values
• Thiazoles (pharmacology, therapeutic use)
• Thiazolidinediones