Urinary Angiotensinogen Could Be a Prognostic Marker of Renoprotective Effects of Alogliptin in Patients with Type 2 Diabetes

Abstract

Background. The aims of this study were (1) to examine the renoprotective effects of alogliptin and (2) to establish urinary angiotensinogen (AGT) as a prognostic marker of renoprotective effects of alogliptin in patients with type 2 diabetes (T2D).Methods. In 43 patients with T2D (18 women,66.1±1.71years), 25 mg/day of alogliptin was added to the traditional hypoglycemic agents and/or nondrug treatments. Urinary concentrations of albumin (Alb) and AGT, normalized by urinary concentrations of creatinine (Cr) (UAlbCR and UAGTCR, respectively), were measured before and after the 12-week alogliptin treatment.Results. Alogliptin treatment tended to decrease UAlbCR (99.6±26.8versus114.6±36.0 mg/g Cr,P=0.198). Based on % change in UAlbCR, patients were divided into two groups, responders (<-25%) and nonresponders (≥-25%), and a logistic analysis of UAGTCR before treatment showed cutoff value of 20.8 µg/g Cr. When all patients were redivided into two groups, those with higher values of UAGTCR before the treatment (Group H,n=20) and those with lower values (Group L), Group H showed significantly decreased UAlbCR in response to alogliptin (-14.6±8.6versus+22.8±16.8%,P=0.033).Conclusion. Urinary AGT could be a prognostic marker of renoprotective effects of alogliptin in patients with T2D.