Urinary TGF-beta1 reduction related to a decrease of systolic blood pressure in patients with type 2 diabetes and clinical diabetic nephropathy

Diabetes Res Clin Pract. 2006 Jun;72(3):258-64. doi: 10.1016/j.diabres.2005.10.027. Epub 2006 Jan 18.

Abstract

With the aim to determine the influence of reducing systolic blood pressure in urinary TGF-beta1 of type 2 diabetes (DM2) with diabetic nephropathy (DN), 21 subjects with type 2 diabetes and proteinuria >500 mg/24 h were studied. Amlodipine and ramipril were added to their previous antihypertensive treatment for 12 weeks. Urinary TGF-beta1 (UTGF-beta1) was determined at 0, 4, 8 and 12 weeks. Plasma TGF-beta1 was determined at 0 and 12 weeks. Subjects whose mean systolic blood pressure (SBP) during treatment were under 140 mmHg were grouped as the better SBP controlled group (n = 11) and those with SBP equal to or greater than 140 mHg were grouped in a moderate SBP controlled group (n = 10). Compared to baseline, mean log UTGF-beta1 at 4, 8 and 12 weeks decreased (-0.22 +/- 0.15 pg/mg; p = 0.04) in better SBP controlled group but not in the moderate SBP controlled group (-0.12 +/- 0.08 pg/mg, p = 0.82). Mean SBP correlated with UTGF-beta1 (r = 0.458, p = 0.0357), and this effect was independent of HbA1c (p = 0.042). By controlling SBP in DM2 subjects with DN we might decrease UTGF-beta1. We propose that reduction of UTGF-beta1 is due to a decrease in renal TGF-beta1 production.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amlodipine / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Atenolol / therapeutic use
  • Blood Glucose / analysis
  • Blood Pressure*
  • Captopril / therapeutic use
  • Creatinine / blood
  • Creatinine / urine
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / urine*
  • Diabetic Nephropathies / blood*
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / urine*
  • Drug Therapy, Combination
  • Enalapril / therapeutic use
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / analysis
  • Humans
  • Hydrochlorothiazide / therapeutic use
  • Hypertension / diet therapy
  • Hypertension / drug therapy
  • Hypertension / urine
  • Male
  • Middle Aged
  • Potassium / blood
  • Propranolol / therapeutic use
  • Ramipril / therapeutic use
  • Transforming Growth Factor beta1 / urine*

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Blood Glucose
  • Glycated Hemoglobin A
  • Transforming Growth Factor beta1
  • Hydrochlorothiazide
  • Amlodipine
  • Atenolol
  • Enalapril
  • Captopril
  • Propranolol
  • Creatinine
  • Ramipril
  • Potassium