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Effect of pioglitazone on urinary liver‐type fatty acid‐binding protein concentrations in diabetes patients with microalbuminuria
Author(s) -
Nakamura Tsukasa,
Sugaya Takeshi,
Kawagoe Yasuhiro,
Ueda Yoshihiko,
Koide Hikaru
Publication year - 2006
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.633
Subject(s) - pioglitazone , microalbuminuria , medicine , nateglinide , urinary system , type 2 diabetes , diabetic nephropathy , endocrinology , nephropathy , urology , gastroenterology , glibenclamide , diabetes mellitus
Background Urinary liver‐type fatty acid‐binding protein (L‐FABP) is a useful marker for renal tubulointerstitial injury. Pioglitazone is reported to be effective in early diabetic nephropathy. The aim of the present study was to determine whether pioglitazone affects urinary L‐FABP levels in diabetic nephropathy patients with microalbuminuria. Methods Sixty‐eight patients with type 2 diabetes and microalbuminuria were randomized to a 12‐month treatment with pioglitazone (30 mg/d, n = 17), glibenclamide (5 mg/d, n = 18), voglibose (0.6 mg/d, n = 17), or nateglinide (270 mg/d, n = 16). Pre‐ and posttreatment urinary albumin excretion (UAE) and urinary L‐FABP concentrations were compared between the four treatment groups and 40 age‐matched healthy subjects. Results Pretreatment UAE and urinary L‐FABP levels differed little between the four groups. UAE and urinary L‐FABP levels were significantly greater in the diabetes patients than in the healthy subjects (UAE: p < 0.001; L‐FABP: p < 0.01). After 6 and 12 months, UAE and urinary L‐FABP were significantly lower in the pioglitazone treatment group than in the other treatment groups (UAE: 6 months, p < 0.01 and 12 months, p < 0.001; L‐FABP: 6 months, p < 0.05 and 12 months, p < 0.01). Conclusions Pioglitazone, but not glibenclamide, voglibose, or nateglinide, appears to be effective in reducing UAE and the urinary L‐FABP level, suggesting that pioglitazone has a specific role in ameliorating both glomerular and tubulointerstitial lesions associated with early diabetic nephropathy. Copyright © 2006 John Wiley & Sons, Ltd.