Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Nephrology Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Diabetes Metab. 2019 Jan;45(1):53-59. doi: 10.1016/j.diabet.2018.05.010. Epub 2018 Jun 8.
Albuminuria is the most important indicator of diabetic nephropathy (DN). Resveratrol, a natural compound found in grape skins and red wine, has antioxidant effects. This study aimed to evaluate the effects of resveratrol on DN.
In this randomized, double-blind, placebo-controlled clinical trial, 60 patients with type 2 diabetes and albuminuria were randomly assigned to receive either resveratrol (500mg/day) or placebo for 90 days. Losartan (12.5mg/day) was also administered to all participants. Primary outcomes were urinary albumin/creatinine ratio, estimated glomerular filtration rate (eGFR) and serum creatinine levels. Secondary outcomes were oxidative stress markers, and anthropometric and biochemical measures.
Mean urine albumin/creatinine ratio was significantly reduced in the resveratrol group vs placebo (-46.4mg/g, 95% CI: -64.5 to -28.3 vs 29.9mg/g, 95% CI: 4.9 to 54.9; P<0.001), whereas eGFR (1.7mL/min/1.73m, 95% CI: -3.4 to 6.8 vs -4.0, 95% CI: -8.2 to 0.2; P=0.08) and serum creatinine (-0.3mg/dL, 95% CI: -0.1 to 0.1 vs 0.1mg/dL, 95% CI: -0.0 to 0.1; P=0.13) were unchanged. Serum antioxidant enzymes were significantly increased with resveratrol. After adjusting for confounding variables, the effect of resveratrol in reducing urinary albumin excretion was still significant (P<0.001). Regression analysis revealed that every 1-cm decrease in waist circumference and 1-μmol/L increase in nitric oxide (NO) was associated with 9.4mg/g and 4.0mg/g reductions, respectively, of urine albumin/creatinine ratio.
This clinical trial has shown that resveratrol may be an effective adjunct to angiotensin receptor blockers (ARBs) for reducing urinary albumin excretion in patients with DN (ClinicalTrials.gov: NCT02704494).
蛋白尿是糖尿病肾病（DN）最重要的指标。白藜芦醇是一种天然存在于葡萄皮和红酒中的化合物，具有抗氧化作用。本研究旨在评估白藜芦醇对 DN 的影响。
在这项随机、双盲、安慰剂对照的临床试验中，将 60 名患有 2 型糖尿病和蛋白尿的患者随机分为接受白藜芦醇（500mg/天）或安慰剂治疗 90 天的两组。所有参与者还服用氯沙坦（12.5mg/天）。主要结局是尿白蛋白/肌酐比值、估算肾小球滤过率（eGFR）和血清肌酐水平。次要结局是氧化应激标志物以及人体测量和生化指标。
与安慰剂组相比，白藜芦醇组的尿白蛋白/肌酐比值显著降低（-46.4mg/g，95%CI：-64.5 至-28.3 比 29.9mg/g，95%CI：4.9 至 54.9；P<0.001），而 eGFR（1.7mL/min/1.73m，95%CI：-3.4 至 6.8 比-4.0，95%CI：-8.2 至 0.2；P=0.08）和血清肌酐（-0.3mg/dL，95%CI：-0.1 至 0.1 比 0.1mg/dL，95%CI：-0.0 至 0.1；P=0.13）无变化。血清抗氧化酶水平随着白藜芦醇的使用而显著增加。在调整混杂变量后，白藜芦醇降低尿白蛋白排泄的效果仍然显著（P<0.001）。回归分析显示，腰围每减少 1cm 和一氧化氮（NO）增加 1μmol/L，尿白蛋白/肌酐比值分别降低 9.4mg/g 和 4.0mg/g。
本临床试验表明，白藜芦醇可能是血管紧张素受体阻滞剂（ARB）的有效辅助治疗，可降低 DN 患者的尿白蛋白排泄量（ClinicalTrials.gov：NCT02704494）。
