However, the renoprotective effects of alogliptin have not been addressed yet. This 12-week study in Japanese patients with T2D was performed to address the renoprotective effects of alogliptin. In addition, urinary angiotensinogen (AGT), a marker of intrarenal renin-angiotensin system (RAS) activity, was examined to demonstrate the clinical usage as a prognostic marker. Methods: Forty-three patients with T2D (18 women, age: 66.1+/-11.2) were recruited in Miyazaki Univ. and its affiliated hospitals, and alogliptin (25 mg/day) was added on the top of the traditional
hypoglycemic buy RAD001 agents. The urinary concentrations of albumin (Alb) and AGT were measured using commercially available ELISA Pifithrin �� kits before and after the alogliptin treatment, and normalized by the urinary
concentration of creatinine (Cr) (UAlbCR and UAGTCR, respectively). Results: The alogliptin treatment tended to decrease UAlbCR (99.6 +/− 26.8 vs. 114.6 +/− 36.0, mg/g Cr). However, this change was not statistically significant (p = 0.1976). Then, we defined good responders to the alogliptin treatment in terms of %change in UAlbCR less than −25% after the 12-week treatment, and a logistic analysis of UAGTCR before the treatment showed the area under curve (AUC) as 0.644. When we set the cutoff value of UAGTCR as 20.8 μg/g Cr, the maximum specificity (17/27 = 63.0%) and sensitivity (10/16 = 62.5%) were obtained (Youden index = 0.255). Based on this cutoff value of UAGTCR before the treatment, we divided all patients into 2 groups as higher (group H, N = 20) and lower (group L) values of UAGTCR at the baseline. %Change in UAlbCR was significantly lower in the group H compared with the group
L (−14.6% +/− 8.6% vs. +22.8% +/− 16.8%, p = 0.0327). These data indicate that the T2D patients with the higher UAGTCR before the treatment would show more decrease in UAlbCR by the alogliptin treatment. Conclusion: Urinary AGT could be a prognostic marker of renoprotective effects of alogliptin in T2D patients. EL-ATTAR HODA,A1, KHALIL GIHANE, I2, GABER EMAN, W3 1Professor in Chemical Pathology Department, MRI, Alexandria University; 2Assistant Professor 2-hydroxyphytanoyl-CoA lyase in Chemical Pathology; 3Assistant Professor in Internal Medicine Introduction: The kidney injury molecule-1 is a type 1 transmembrane glycoprotein (339 a a). KIM-1 ectodomain is cleaved and shed in a metalloproteinase-dependent fashion. The soluble KIM-1 protein that appears in the urine of humans is about 90 KDa. All forms of chronic kidney disease, including diabetes, are associated with tubulo-interstitial injury. Aim: The determination of (KIM-1) level in the urine of patients with type 2 diabetes in order to evaluate it as an early diagnostic parameter for diabetic nephropathy in comparison to urinary albumin excretion.
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