Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/9405
Title: Urinary transforming growth factor-beta excretion in patients with hypertension, type 2 diabetes, and elevated albumin excretion rate: effects of angiotensin receptor blockade and sodium restriction.
Authors: Houlihan, Christine A;Akdeniz, Aysel;Tsalamandris, Con;Cooper, Mark E;Jerums, George;Gilbert, Richard E
Affiliation: University of Melbourne, Department of Medicine at Austin, Victoria, Australia.
Issue Date: 1-Jun-2002
Citation: Diabetes Care; 25(6): 1072-7
Abstract: Transforming growth factor-beta (TGF-beta) is a prosclerotic growth factor implicated in the pathogenesis of diabetic nephropathy. In addition to high glucose, other factors implicated in renal fibrosis and increased TGF-beta synthesis include angiotensin II and high dietary sodium intake. The aim of this study was to examine the effect of angiotensin receptor blockade (ARB) and dietary sodium restriction on the plasma concentration and urinary excretion of TGF-beta in hypertensive patients with type 2 diabetes and elevated albumin excretion rate (AER).Twenty-one subjects with hypertension and AER between 10 and 200 microg/min were randomized to receive either 50 mg losartan daily (n = 11) or placebo (n = 10). Drug therapy was given in two 4-week phases, separated by a 4-week washout period. In the last 2 weeks of each phase, patients were assigned to regular- or low-sodium diets in random order. Parameters measured at week 0 and 4 of each phase included plasma TGF-beta concentration, TGF-beta urinary excretion, AER, clinic mean arterial blood pressure, and urinary sodium excretion.Plasma TGF-beta was unaffected by losartan treatment or sodium intake. In the losartan group, urinary TGF-beta excretion decreased by 23.2% (-39.2 and 13.6) [median (interquartile range)] and 38.5% (-46.8 and -6.1) in the regular- and low-sodium phases, respectively (P < 0.05 for drug effect). In the placebo group, median changes of 0.0% (-12.1 and 44.4) and 0.0% (-29.2 and 110.7) occurred in the regular- and low-sodium phases, respectively. Sodium restriction did not affect urinary TGF-beta excretion in either losartan- or placebo-treated patients (P = 0.54 for overall dietary effect), and there was no evidence of interaction between drug and diet (P = 0.29).In hypertensive type 2 diabetic patients with elevated AER, the ARB losartan, but not sodium restriction, reduced urinary TGF-beta excretion. These data suggest that the renoprotective effects of losartan in patients with type 2 diabetes and nephropathy may include a reduction in renal TGF-beta production.
Internal ID Number: 12032117
URI: http://ahro.austin.org.au/austinjspui/handle/1/9405
URL: http://www.ncbi.nlm.nih.gov/pubmed/12032117
Type: Journal Article
Subjects: Albuminuria
Analysis of Variance
Angiotensin Receptor Antagonists
Antihypertensive Agents.therapeutic use
Blood Pressure
Body Mass Index
Diabetes Mellitus, Type 2.blood.physiopathology.urine
Diabetic Angiopathies.urine
Diet, Sodium-Restricted
Female
Hemoglobin A, Glycosylated.analysis
Humans
Hypertension.blood.urine
Losartan.therapeutic use
Male
Middle Aged
Placebos
Regression Analysis
Sodium.urine
Transforming Growth Factor beta.urine
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.