E. Esmatjes et al., Effect of losartan on TGF-beta 1 and urinary albumin excretion in patientswith type 2 diabetes mellitus and microalbuminuria, NEPH DIAL T, 16, 2001, pp. 90-93
Background. The aim of the present study was to determine the effect of los
artan on transforming growth factor-beta1 (TGF-beta1) plasma levels and uri
nary albumin excretion (UAE) in patients with type 2 diabetes mellitus, mil
d hypertension and microalbuminuria.
Methods. Fourteen patients (eight males, aged 55+/-6 years) with type 2 dia
betes mellitus, mild arterial hypertension and microalbuminuria, participat
ing in an open, uncontrolled, pilot study were included. Patients were trea
ted for 8 weeks with losartan. TGF-beta1 plasma levels, UAE and 24-h blood
pressure monitoring were determined at baseline and at 4 and 8 weeks.
Results. At 4 and 8 weeks of treatment, a reduction was observed in TGF-bet
a1 plasma levels (5.5+/-4.5 vs 2.0 +/- 0.6 and 2.6 +/- 1.0 ng/ml, P < 0.005
), UAE (96 +/- 65 vs 59 +/- 59. and 64 +/- 47 <mu>g/min, P < 0.01), 24-h sy
stolic blood pressure (136 +/- 9 vs 129 +/- 9 and 130 +/- 10 mmHg, P < 0.01
) and 24-h diastolic blood pressure (77 +/- 9 vs 74 +/- 8 and 74 +/- 7 mmHg
, P < 0.03). Stratifying the patients by baseline TGF-<beta>1, seven had TG
F-beta1 plasma values higher than normal controls. At 4 and 8 weeks, they s
howed a marked reduction in TGF-beta1 values (9.0 +/- 3.9 to 2.1 +/- 0.7 an
d 2.5 +/- 0.7 ng/ml, P < 0.01) and UAE (106 +/- 83 to 49 +/- 42 and 38 +/-
26 <mu>g/min, P < 0.05), with good correlation between the percentage reduc
tion of both parameters (r=0.83, P<0.01). The remaining seven patients, wit
h normal baseline TGF-beta1 plasma levels, showed no change in TGF-beta1 pl
asma levels and UAE after treatment.
Conclusion. Treatment with losartan decreases TGF-beta1 plasma values and U
AE in type 2 diabetes mellitus patients with high baseline TGF-beta1 levels
, suggesting that TGF-beta1 may be a marker to detect patients who may part
icularly benefit from renin angiotensin system blockade.