Effectiveness of Valsartan in Obese Versus Non-Obese Type 2 Diabetic patients presented with microalbuminuria

Abstract

Aim: To ascertain efficacy of Valsartan, an angiotensin receptor blocker (ARB) in reducing microalbuminuria in obese verses non obese patients. Methods: This comparative study was done in Department of Nephrology Pakistan Institute of Medical Sciences Islamabad from July 1, 2018 to December 31, 1018. Patients fulfilling selection criteria were enrolled and categorized as two groups obese & non-obese; both groups were given valsartan. Urine ACR and serum creatinine was followed every month for 6 months. Results: Average age of all cases as 52.06 ± 4.11 years while the mean age in obese and non-obese cases was 52.48 ± 4.25 years and 51.63 ± 3.95 years, respectively. The mean change in Urine ACR (from baseline to 6th months) in obese cases was 41.76 ± 25.81 and non-obese cases was 76.05 ± 7.63, p-value <0.001. In obese cases mean urine ACR at 1st and 2nd month was same from baseline, p-value > 0.05 while at 3rd, 4th month was statistically lower as compare to baseline urine ACR, p-value < 0.05. Moreover, in non-obese cases the mean urine ACR was statistically decreased at 1st, 2nd, 3rd, 4th, 5th and 6th month when compared with baseline, p-value < 0.001. At 4th month in obese cases none of the cases achieved ACR < 30 while in non-obese cases 4(7.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.05. At 4th month in obese cases 12(22.2%) cases achieved ACR < 30 while in non-obese cases 31(57.4%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. At 6th month in obese cases 20(37%) cases achieved ACR < 30 while in non-obese cases 41(75.9%) cases achieved ACR < 30 with significantly higher frequency in non-obese cases, p-value < 0.001. Conclusion: Valsartan is more effective in reducing microalbuminuria in non-obese patients as compared to obese patients. Keywords: Diabetes mellitus, obesity, microalbuminuria, Valsartan