Clinical Diabetes 2007;8(1):81-90.
고혈압이 동반된 제2형 당뇨병환자에서 Candesartan이 혈중 Matrix Metalloproteinase (MMP) 및 Tissue Inhibitor of Metalloproteinase (TIMP)에 미치는 영향
조민호, 유소영, 정한영, 윤지은, 남지선, 김혜진, 박종숙, 김철식, 하헌주, 곽혜선, 강은석, 김형진, 안철우, 차봉수, 송영득, 임승길, 김경래, 이현철
Effect of Candesartan to Plasma MMPs and TIMPs in Hypertensive Type 2 Diabetic Patients
Min Ho Cho, So Young Yoo, Han Young Jung, Ji Eun Yoon, Ji Sun Nam, Hai Jin Kim, Jong Suk Park, Chul Sik Kim, Hun Joo Ha, Hye Sun Gwak, Eun Seok Kang, Hyung Jin Kim, Chul Woo Ahn, Bong Soo Cha, Young Duk Song, Sung Kil Lim, Kyung Rae Kim, Hyun Chul Lee
Abstract
Background
s: Candesartan, an angiotensin Ⅱ receptor antagonist has been reported to have an antiproteinuric effect and increase insulin sensitivity with diabetic nephropathy. The aim of this study was to test whether candesartan affects proteinuria, insulin sensitivity, and serum MMP (matrix metalloproteinase)-2, MMP-9, TIMP (tissue inhibitor of metalloproteinase)-1, and TIMP-2. Method: Total of 111 patients were enrolled in this study: 29 patients who have type 2 diabetes with an albumin excretion rate of over 30 mg/day, 33 patients who have type 2 diabetes with an albumin excretion rate of 30 mg/day or less and 49 healthy controls. 62 patients with type 2 diabetes took 8-16 mg/day of candesarta for 12 weeks and the following parameters were determined: weight, height, diastolic blood pressure (DBP), systolic blood pressure (SBP), duration of diabetes, age, biochemical parameters, MMP-2, MMP-9, TIMP-1, and TIMP-2 levels. Results: There was no significant difference in BMI, DBP, SBP, duration of diabetes, age, biochemical parameters except for albumin excretion rate between diabetic patients with and without nephropathy. The serum concentrations of MMP-2, MMP-9, TIMP-1 and TIMP-2 increased after the treatment in both diabetic patients. Insulin sensitivity also increased after candesartan treatment. Conclusions: Candesartan administration for 12 weeks was effective in decreasing hypertension, decreasing insulin resistance and serum concentrations of MMP-2, MMP-9, TIMP-1 and TIMP-2 for both patients with diabetes and diabetic nephropathy.
Key Words: Diabetic nephropathy, Insulin resistance, MMPs, TIMPs
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