アンギオテンシノーゲン遺伝子235T alleleを有する2型糖尿病腎症患者におけるACE阻害剤とARB併用によるアルブミン尿改善効果

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We evaluated the combination therapy of angiotensin-converting-enzyme inhibitor (ACE-I) andangiotensin II type 1 receptor blocker (ARB) offered an additional effect in reduction of albuminuria in type2 diabetic patients with angiotensinogen (AGT) M235T polymorphism. The study subjects were type 2diabetic patients with nephropathy who were attending Hirosaki University Hospital. Fifteen patients with235T allele (TT genotype 9, MT genotype 6) were evaluated who had diabetic nephropathy in stage 2 or 3and already treated with ACE-I. Each patient administrated ARB (20-40 mg of termisartan) in addition toACE-I for 16 weeks as the combination therapy. The addition of termisartan induced a significant reductionin systolic blood pressure (BP) of 14.0 mmHg and diastolic BP of 5.4mmHg. The urinary albumin-creatinineratio (ACR) was also reduced to 48.9%. There was no significant correlation between the reduction rate ofACR and the antihypertensive response of systolic blood pressure (BP) (rs = 0.1277) and of diastolic BP (rs=0.1420) by the addition of termisartan. These results indicated that the combination of ACE-I and ARBhad an additional effect on urinary albumin excretion in type 2 diabetic patients with AGT 235T allele.
弘前大学の論文