Pioglitazone delays proximal tubule dysfunction and improves cerebral vessel endothelial dysfunction in normoalbuminuric people with type 2 diabetes mellitus.

摘要: Abstract Aim The renal and cerebral protective effects of pioglitazone were assessed in normoalbuminuric patients with type 2 diabetes mellitus (DM). Methods A total 68 DM enrolled a one-year open-label randomized controlled trial: 34 (pioglitazone-metformin) vs. (glimepiride-metformin). All concerning urinary albumin: creatinine ratio (UACR), alpha1-microglobulin, beta2-microglobulin, plasma asymmetric dymethyl-arginine (ADMA), GFR, hsC-reactive protein, fibrinogen, HbA1c; pulsatility index, resistance index the internal carotid artery middle artery, intima-media thickness common artery; cerebrovascular reactivity was evaluated through breath-holding test. Results At 1 year there differences between groups regarding ADMA, parameters inflammation, serum creatinine, UACR, haemodynamic indices. Significant correlations found alpha 1-microglobulin-UACR ( R  = 0.143; P  = 0.001) GFR  = 0.081;  = 0.01); beta2-microglobulin-UACR  = 0.241;  = 0.0001)  = 0.064;  = 0.036); ADMA–GFR  = 0.338;  = 0.0001), HbA1c, duration DM, There no ADMA–UACR, alpha1-microglobulin beta2-microglobulin. Conclusion Proximal tubule (PT) dysfunction precedes albuminuria is dissociated from endothelial DM. Pioglitazone delays PT improves vessels Key words: proximal tubule; dysfunction, albuminuria; pioglitazone.