scholarly journals Reno-protective effect of angiotensin converting enzyme inhibitor and angiotensin II receptor blockers in type 2 diabetic nephropathy with elevated urine albumin to creatinine ratio

2019 ◽  
Vol 6 (3) ◽  
pp. 657
Author(s):  
Ashok Vankayala ◽  
Karuna Sagar Mantha ◽  
Praveen Varma B. H. V. K. ◽  
Suresh Babu Sayana ◽  
Raju D. S. S. K.
Keyword(s):  
Diabetic Nephropathy ◽  
Angiotensin Ii ◽  
Enzyme Inhibitor ◽  
Creatinine Ratio ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Urine Albumin ◽  
Type 2 Diabetics ◽  
Receptor Blockers

Background: Nephropathy is responsible for an End Stage Renal Disease (ESRD) in type 2 diabetics if uncontrolled. The monotherapy/combination of Angiotensin Converting Enzyme inhibitor (ACEi) and Angiotensin II Receptor Blockers (ARBs) can retard the progression of urine albumin to creatinine ratio in diabetic nephropathy but, the data shows an inconsistency in the efficacy of these drugs. So, the present study was aimed at comparing the reno-protective effect of ACEi/ARBs in type 2 diabetics.Methods: A prospective, randomized study is conducted at Maharaja’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhra Pradesh, India with 100 patients, who are randomly categorised and equally distributed among the two groups and treated with Enalapril (ACEi) and Losartan (ARBs) for 6 months. 24-hour urine albumin to creatinine ratio and HbA1c are recorded before and after the treatment.Results: Enalapril and losartan showed a non-significant reduction in urine albumin to creatinine ratio from 196.2±17.5 to 185.9±15.2 (p=0.66) and 236.8±16.3 to 193.7±20.6 (p=0.11) respectively. A strict glycemic control has shown a reduction in HbA1c in both the groups.Conclusions: Present findings suggested that losartan is relatively more effective than enalapril in reducing the 24-hour urine albumin to creatinine ratio of diabetic nephropathy patients. Along with these drugs, regulation of blood glucose will assist in retarding the progression of nephropathy in type 2 diabetics.

scholarly journals Increased serum asprosin is correlated with diabetic nephropathy

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rui Wang ◽  
Peng Lin ◽  
Huibo Sun ◽  
Wenchao Hu
Keyword(s):  
Diabetic Nephropathy ◽  
Enzyme Inhibitor ◽  
Hepatic Glucose Production ◽  
Glucose Production ◽  
Angiotensin Ii Receptor Blocker ◽  
Channel Blockers ◽  
Angiotensin Ii Receptor ◽  
Urine Albumin ◽  
Hepatic Glucose

Abstract Objective The adipokine asprosin, which was recently discovered, facilitates hepatic glucose production. The aim of this study is to see whether serum asprosin concentrations are linked to diabetic nephropathy (DN). Methods We performed this investigation in a group of 212 type 2 diabetes (T2DM) patients. These patients were classified into three subgroups: DN0 group (normal to mildly increased), DN1 group (moderately increased), and DN2 group (severely increased) on the basis of urine albumin-to-creatinine ratio (ACR). Results When compared to the controls, T2DM patients had higher serum asprosin levels. The DN2 group had significantly higher serum asprosin than the DN0 and DN1 groups. Furthermore, the DN1 group had higher serum asprosin than the DN0 group. Serum asprosin was linked to a higher risk of T2DM and DN in a logistic regression analysis. Serum asprosin was found to be positively related with disease duration, systolic blood pressure, blood urea nitrogen, creatinine, uric acid, ACR, calcium channel blockers, and angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker therapy, but negatively related with glomerular filtration rate, metformin, and acarbose therapy. Conclusion Serum asprosin increase with the progression of DN. Serum asprosin is correlated with renal function and ACR.

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