Rosiglitazone reduces urinary albumin excretion in type II diabetes

Abstract

This study examines the effect of rosiglitazone on urinary albumin excretion (UAE) in patients with type II diabetes. Urinary albumin : creatinine ratio (ACR) was measured in a 52-week, open-label, cardiac safety study comparing rosiglitazone and glyburide. Patients were randomised to treatment with rosiglitazone 4 mg b.i.d. or glyburide. ACR was measured at baseline and after 28 and 52 weeks of treatment. Statistically significant reductions from baseline in ACR were observed in both treatment groups at week 28. By week 52, only the rosiglitazone group showed a significant reduction from baseline. Similar results were observed for the overall study population and for the subset of patients with baseline microalbuminuria. For patients with microalbuminuria at baseline, reductions in ACR did not correlate strongly with reductions in glycosylated haemoglobin, or fasting plasma glucose, but showed strong correlation with changes in mean 24-h systolic and diastolic blood pressure for rosiglitazone-treated patients (DACR vs Dmean 24-h systolic blood pressure, r ¼ 0.875; DACR vs Dmean 24-h diastolic blood pressure, r ¼ 0.755; Po0.05 for both). No such correlation was observed for glyburide-treated patients. In conclusion, rosiglitazone treatment was associated with a decrease in urinary albumin excretion. These findings suggest a potential beneficial effect of rosiglitazone in the treatment or prevention of renal and vascular complications of type II diabetes.

Renal Function in Type 2 Diabetes with Rosiglitazone, Metformin, and Glyburide Monotherapy

“…BP was also reduced to a greater extent with rosiglitazone than either metformin or glyburide, particularly DBP. These modest differences in office BP were consistent with previous reports that either used casual BP measurements (23,24) or, more importantly, monitored 24-hour ambulatory BP (25,26). In our study the effect was independent of pre-existing hypertension, or treatment with ACEi, ARBs, or calcium channel blockers over time, or the level of glycemia.…”

Systemic and renal growth hormone–IGF1 axis involvement in a mouse model of type 2 diabetes

“…Possible interventions in this model could then include an improvement in renal insulin signalling [35,36]. This is exemplified by the use of insulin sensitisers in humans, such as peroxisome proliferator-activated receptor gamma agonists, which have been beneficial in the treatment of renal injury in early diabetic nephropathy [37,38]. The potential role of restoring GH levels [39] and the particular independent effects of renal IGFBP1 accumulation remain to be determined.…”

The Effect of Rosiglitazone and Metformin Therapy, as an Initial Therapy, in Patients with Type 2 Diabetes Mellitus

“…Among the oral hypoglycemic agents, rosiglitazone, in comparison to glyburide, has been shown to decrease urinary albumin excretion in type 2 diabetes patients. This suggests a beneficial effect of rosiglitazone in the prevention of renal complications related to type 2 diabetes 20) . In the RSG/MET group, there was a reduction in urinary ACR compared to baseline, but it was not significant when compared to those of the RSG and MET groups.…”