Journal Article

Irbesartan treatment does not influence plasma levels of the advanced glycation end products <i>N</i><sup>ε</sup>(1-carboxymethyl)lysine and <i>N</i><sup>ε</sup>(1-carboxyethyl)lysine in patients with type 2 diabetes and microalbuminuria. A randomized controlled trial

Lian Engelen, Frederik Persson, Isabel Ferreira, Peter Rossing, Peter Hovind, Tom Teerlink, Coen D. Stehouwer, Hans-Henrik Parving and Casper G. Schalkwijk

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 11, pages 3573-3577
Published in print November 2011 | ISSN: 0931-0509
Published online March 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr102
Irbesartan treatment does not influence plasma levels of the advanced glycation end products Nε(1-carboxymethyl)lysine and Nε(1-carboxyethyl)lysine in patients with type 2 diabetes and microalbuminuria. A randomized controlled trial

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Background. In vitro and animal experiments have shown inhibiting effects of angiotensin receptor blockers (ARBs) on the formation of advanced glycation end products (AGEs), which are known to be involved in the development of cardiovascular complications in diabetes. However, sufficient human data to confirm such beneficial effects of ARBs on AGEs are lacking. Therefore, we investigated the effects of irbesartan treatment on plasma levels of the AGEs Nε(1-carboxymethyl)lysine (CML) and Nε(1-carboxyethyl)lysine (CEL) in hypertensive patients with type 2 diabetes and microalbuminuria.

Methods. We analysed data from a multicentre, double-blind, parallel, randomized controlled trial in patients with type 2 diabetes and microalbuminuria, the primary goal of which was to examine the renoprotective effects of irbesartan treatment (150 or 300 mg daily). Secondary end points included plasma CML and CEL in the treatment arm receiving 300 mg irbesartan (n = 139) and in the placebo group (n = 125). Effects of treatment at 1- and 2-year follow-up were analysed by means of generalized estimating equations according to an intention-to-treat principle.

Results. Levels of CML and CEL did not differ between groups at baseline. No significant changes were observed in CML and CEL over time in either group and there was no effect of treatment on CML and CEL at any time-point. Mean differences for the irbesartan versus placebo group over time were −0.96 μmol/mol lysine (95% confidence interval: −3.43 to 1.51) for CML and −0.10 μmol/mol lysine (−0.76 to 0.56) for CEL.

Conclusions. Long-term irbesartan treatment does not influence plasma levels of the AGE CML and CEL in patients with type 2 diabetes and microalbuminuria.

Keywords: advanced glycation end products; albuminuria; angiotensin II type I receptor blockers; hypertension; irbesartan; type 2 diabetes

Journal Article.  2625 words.  Illustrated.

Subjects: Nephrology

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