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西立伐他汀对伴有微量白蛋白尿和血脂异常的2型糖尿病患者尿白蛋白排泄及血浆内皮素-1浓度的影响。

Effect of cerivastatin on urinary albumin excretion and plasma endothelin-1 concentrations in type 2 diabetes patients with microalbuminuria and dyslipidemia.

作者信息

Nakamura T, Ushiyama C, Hirokawa K, Osada S, Shimada N, Koide H

机构信息

Department of Medicine, Misato Junshin Hospital, Saitama, Japan.

出版信息

Am J Nephrol. 2001 Nov-Dec;21(6):449-54. doi: 10.1159/000046648.

Abstract

BACKGROUND/AIMS: To determine whether cerivastatin, a newly developed novel synthetic potent statin, exerts a renoprotective effect, we assessed urinary albumin excretion (UAE) and plasma and urinary endothelin (ET)-1 concentrations in normotensive microalbuminuric type 2 diabetes patients with dyslipidemia.

METHODS

Sixty normotensive type 2 diabetic patients (38 men and 22 women; mean age 56.5 years) with microalbuminuria (20-200 microg/min) and dyslipidemia (total cholesterol >200 mg/dl, LDL cholesterol >160 mg/dl, HDL cholesterol <35 mg/dl, and triglyceride >150 mg/dl) were enrolled in a double-blind study for 6 months, receiving either cerivastatin (0.15 mg/day) or placebo. Plasma and urinary ET-1 concentrations were measured by radioimmunoassay.

RESULTS

Cerivastatin did not affect serum creatinine and HbA(1c) levels, and reduced systolic blood pressure slightly, but not significantly. Plasma levels of total cholesterol and LDL cholesterol were significantly reduced (p < 0.01), and plasma triglyceride levels were also reduced significantly (p < 0.05) after 6 months of cerivastatin treatment. A concomitant significant decrease in UAE (p < 0.01), and urinary and plasma ET-1 concentrations (p < 0.01) were found during this period.

CONCLUSION

The use of cerivastatin is associated with decreased microalbuminuria and plasma and urinary ET-1 levels in microalbuminuric patients with type 2 diabetic mellitus and speculate that this may represent an amelioration of renal injury.

摘要

背景/目的:为了确定新开发的新型强效合成他汀类药物西立伐他汀是否具有肾脏保护作用,我们评估了血压正常的微量白蛋白尿型2型糖尿病血脂异常患者的尿白蛋白排泄量(UAE)以及血浆和尿液中内皮素(ET)-1的浓度。

方法

60例血压正常的2型糖尿病患者(38例男性和22例女性;平均年龄56.5岁),伴有微量白蛋白尿(20 - 200微克/分钟)和血脂异常(总胆固醇>200毫克/分升,低密度脂蛋白胆固醇>160毫克/分升,高密度脂蛋白胆固醇<35毫克/分升,甘油三酯>150毫克/分升),参加了一项为期6个月的双盲研究,接受西立伐他汀(0.15毫克/天)或安慰剂治疗。通过放射免疫分析法测量血浆和尿液中ET-1的浓度。

结果

西立伐他汀不影响血清肌酐和糖化血红蛋白(HbA1c)水平,可轻微降低收缩压,但不显著。西立伐他汀治疗6个月后,血浆总胆固醇和低密度脂蛋白胆固醇水平显著降低(p<0.01),血浆甘油三酯水平也显著降低(p<0.05)。在此期间,UAE(p<0.01)以及尿液和血浆中ET-1浓度(p<0.01)均显著下降。

结论

在微量白蛋白尿的2型糖尿病患者中,使用西立伐他汀与微量白蛋白尿以及血浆和尿液中ET-水平降低有关,并推测这可能代表肾脏损伤的改善。

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