Pourshabanan Pejman, Momeni Ali, Mahmoudnia Leila, Kheiri Soleiman
Shahrekord University of Medical Sciences, Shahrekord, Iran.
Shahrekord University of Medical Sciences, Shahrekord, Iran.
Diabetes Metab Syndr. 2019 Jan-Feb;13(1):132-136. doi: 10.1016/j.dsx.2018.04.013. Epub 2018 Apr 10.
Diabetic nephropathy that means albuminuria greater than 30 mg/day, affects about one third of diabetic patients. There are many studies about the effect of different medications for diabetic nephropathy with controversy in their results. So, the aim of the study was to investigate the effect of pioglitazone on decreasing of proteinuria in type II diabetic patients and nephropathy.
It is a double blind clinical trial. At first, 2356 medical carts of the patients were evaluated and 76 patients with type 2 diabetes mellitus with proteinuria greater than 250 mg / day were enrolled in 2 equal groups. In the case group, pioglitazone 15 mg/day was prescribed and patients in the control group received placebo for two months. At the beginning of the study and after 2 months, urinary protein during 24 h was measured in all of the patients and data were entered to SPSS (version23) and evaluated by using Chi- square, Mc Nemar, paired t-test and logistic regression model.
At the beginning of the study, urine protein during 24 h in the case and control groups were 957.7 ± 385.1 and 972.1 ± 378.6 respectively (P = .872). So, after 2 months the mean proteinuria in the case and control groups were 647.3 ± 367.2 and 896 ± 372.4 respectively that is valuable (P = 0.005). Pioglitazone had the considerable effect on FBS,HbA1c and blood triglyceride too.
The study showed that low dose of pioglitazone is an effective, safe and inexpensive method in reducing of proteinuria in type2 diabetic patients with nephropathy.
糖尿病肾病是指蛋白尿大于30毫克/天，约三分之一的糖尿病患者受其影响。关于不同药物对糖尿病肾病的影响有很多研究，但其结果存在争议。因此，本研究的目的是探讨吡格列酮对降低II型糖尿病患者蛋白尿及肾病的影响。
这是一项双盲临床试验。首先，对2356名患者的病历进行评估，将76名蛋白尿大于250毫克/天的2型糖尿病患者分为两组。病例组给予吡格列酮15毫克/天，对照组患者接受安慰剂治疗两个月。在研究开始时和2个月后，测量所有患者24小时尿蛋白，数据录入SPSS（版本23），并采用卡方检验、麦克尼马尔检验、配对t检验和逻辑回归模型进行评估。
研究开始时，病例组和对照组24小时尿蛋白分别为957.7±385.1和972.1±378.6（P = 0.872）。因此，2个月后，病例组和对照组的平均蛋白尿分别为647.3±367.2和896±372.4，差异有统计学意义（P = 0.005）。吡格列酮对空腹血糖、糖化血红蛋白和血甘油三酯也有显著影响。
该研究表明，低剂量吡格列酮是降低2型糖尿病肾病患者蛋白尿的一种有效、安全且廉价的方法。
