Effect of Angiotensin Receptor Inhibitors on Endothelial Dysfunction

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Pediatrics, Nephrology Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

2 Associate Professor, Department of Physilology, Physiology Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

3 Resident, Department of Pediatrics, Child Health Promotion Research Center And Student Research Committee, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

4 Professor, Department of Endocrinology, Endocrine and Metabolism Research Center, School of Medicine, Isfahan University of Medical sciences, Isfahan, Iran

Abstract

Background: Children and teenager with diabetes type I (IDDM or Insulin dependent diabetes mellitus) are strongly at risk for diabetic nephropathy in adolescents and adulthood. Treatment of endothelial dysfunction can increase the longevity of these patients. The aim of this study was to evaluate the effect of angiotensin receptor blockers (ARBs or Angiotensin receptor blockers) in endothelial dysfunction indices in patients with diabetic nephropathy.Methods: This prospective clinical trial study was conducted between 2010 and 2011 in Isfahan, Iran. 32 patients with diabetic nephropathy that their microalbuminuria has been proved in two urine samples were enrolled in the study. All of the studied patients were treated with valsartan (an ARBs medication) for one month. The level of nitric oxide (NO), vascular cell adhesion molecule (VCAM) and Fetuin-A was measured before and after the treatment period.Findings: The mean age of patients was 24.66 ± 2.16 years. 34.4% of petients were men. Before the intervention, the level of Fetuin-A was o.36 ± 0.03 mg/dl and after intervention it declined to 0.25 ± 0.02 mg/dl. The mean level of NO before and after the intervention was respectively 0.23 ± 0.01 and 0.29 ± 0.01 mg/dl. The level of VCAM was 0.251 ± 18.5 ng/ml before the intervention and 211.5 ± 11.2 ng/ml after it. Conclusion: The evidence of this showed that the Valsartan medication or other angiotensin receptor inhibitors can be effective can improve endothelial function. Therefore, it is recommended to improve endothelial function of drugs used angiotensin.

Keywords

References

  1. Breyer JA. Diabetic nephropathy in insulin-dependent patients. Am J Kidney Dis 1992; 20(6): 533-47.
  2. Hostetter TH. Diabetic nephropathy. In: Brenner BM, Rector FC, editors. Brenner & Rector's the kidney. 8th ed. Philadelphia: Saunders Elsevier; 2008. p. 1377-402.
  3. Milovanceva-Popovska M, Dzikova S. Progression of diabetic nephropathy: value of intrarenal resistive index (RI). Prilozi 2007; 28(1): 69-79.
  4. Schweiger MJ, Cannon CP, Murphy SA, Gibson CM, Cook JR, Giugliano RP, et al. Early coronary intervention following pharmacologic therapy for acute myocardial infarction (the combined TIMI 10B-TIMI 14 experience). Am J Cardiol 2001; 88(8): 831-6.
  5. Hume DZ, Drobatz KJ, Hess RS. Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). J Vet Intern Med 2006; 20(3): 547-55.
  6. Otieno CF, Kayima JK, Omonge EO, Oyoo GO. Diabetic ketoacidosis: risk factors, mechanisms and management strategies in sub-Saharan Africa: a review. East Afr Med J 2005; 82(12 Suppl): S197-S203.
  7. Chen HY, Chiu YL, Hsu SP, Pai MF, Lai CF, Peng YS, et al. Association of serum fetuin A with truncal obesity and dyslipidemia in non-diabetic hemodialysis patients. Eur J Endocrinol 2009; 160(5): 777-83.
  8. Porazko T, Kuzniar J, Kusztal M, Kuzniar TJ, Weyde W, Kuriata-Kordek M, et al. IL-18 is involved in vascular injury in end-stage renal disease patients. Nephrol Dial Transplant 2009; 24(2): 589-96.
  9. Caglar K, Yilmaz MI, Saglam M, Cakir E, Kilic S, Sonmez A, et al. Serum fetuin-a concentration and endothelial dysfunction in chronic kidney disease. Nephron Clin Pract 2008; 108(3): c233-40.
  10. Matsumoto Y, Adams V, Jacob S, Mangner N, Schuler G, Linke A. Regular exercise training prevents aortic valve disease in low-density lipoprotein-receptor-deficient mice. Circulation 2010; 121(6): 759-67.
  11. Donnini S, Terzuoli E, Ziche M, Morbidelli L. Sulfhydryl angiotensin-converting enzyme inhibitor promotes endothelial cell survival through nitric-oxide synthase, fibroblast growth factor-2, and telomerase cross-talk. J Pharmacol Exp Ther 2010; 332(3): 776-84.
  12. Zdionchenko VS, Leksina KS, Timofeeva NI, Shekhian GG, Bagatyrova KM, Mironova MA. [Effect of angiotensin converting enzyme inhibitors on oxidative stress, endothelial function in patients with myocardial infarction]. Kardiologiia 2009; 49(7-8): 32-7.
Journal of Isfahan Medical School
Volume 29, Issue 152 - Serial Number 152
July and August 2011
Pages 1224-1228

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History

  • Receive Date: 11 June 2011
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

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