Effects Of Pioglitazone On The Serum AGE-P And MCP-1 In The Patients With Diabetic Nephropathy

Objectives: Chemokines may play an important role in the pathogenesis of diabetic nephropathy. Advanced glycation end products (AGEs) induces several fibrogenic chemokines, such as monocyte chemoattractant protein-1 (MCP-1). The progression of diabetic nephropathy can be retarded by pioglitazone in type 2 diabetic patients. The aim of this study was to investigate the effect of pioglitazone on the serum AGE-P and MCP-1 in the type 2 diabetic patients.Methods:60 type 2 diabetic patients with microalbuminuria (UMA/creatinine 30-300μg.mg-1) were included, and treated with pioglitazone or glipizide, respectively. The serum MCP-1 concentration was measured by enzyme-linked immunosorbent assay (ELISA). The serum AGE-P concentration was measured by flow injection assay. The values were analyzed by ANOVA and Student Newman Keuls Test (NK).Results: 1) The levels of AGE-P in the pioglitazone group were significantly lower than those in the glipizide group (3 months: 1.63±0.17 vs 2.21±0.18 u.mol-1, P<0.05; 6 months: 1.19±0.11 vs 2.00±0.12 u.mol-1, P<0.001).2) The levels of MCP-1 in the pioglitazone group were also lower than those in the glipizide group (3months: 251.60±23.09 vs 299.31±37.75 pg.ml-1, P<0.05; 6 months: 188.12±19.97 vs 277.01±28.17 pg.ml-1,P<0.001).3) The levels of△U MA was correlated positively with the levels of△AGE-P (r=0.60, P<0.001) and the levels of△MCP-1 (r=0.71, P<0.001); The levels of△MCP-1 was also correlated positively with the levels of△AGE-P (r=0.74, p<0.001). Conclusions: Pioglitazone reduces the serum AGE-P and MCP-1 levels elevated in the patients with type 2 diabetic nephropathy. It suggests that pioglitazone might play the role of reno-protection through suppression of the serum AGE-P and MCP-1.