Effects of the peroxisome proliferator-activated receptor (PPAR)-gamma agonist pioglitazone on renal and hormonal responses to salt in diabetic and hypertensive individuals.

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Serval ID
serval:BIB_2DCD23BF24A5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effects of the peroxisome proliferator-activated receptor (PPAR)-gamma agonist pioglitazone on renal and hormonal responses to salt in diabetic and hypertensive individuals.
Journal
Diabetologia
Author(s)
Zanchi A., Maillard M., Jornayvaz F.R., Vinciguerra M., Deleaval P., Nussberger J., Burnier M., Pechere-Bertschi A.
ISSN
1432-0428[electronic], 0012-186X[linking]
Publication state
Published
Issued date
2010
Volume
53
Number
8
Pages
1568-1575
Language
english
Abstract
Aims/Hypothesis: Glitazones are powerful insulin sensitisers prescribed for the treatment of type 2 diabetes. Their use is, however, associated with fluid retention and an increased risk of congestive heart failure. We previously demonstrated that pioglitazone increases proximal sodium reabsorption in healthy volunteers. This study examines the effects of pioglitazone on renal sodium handling in individuals prone to insulin resistance, i.e. those with diabetes and/or hypertension.
Methods: In this double-blind randomised placebo-controlled four-way crossover study, we examined the effects of pioglitazone (45 mg daily during 6 weeks) or placebo on renal, systemic and hormonal responses to changes in sodium intake in 16 individuals, eight with type 2 diabetes and eight with hypertension.
Results: Pioglitazone was associated with a rapid increase in body weight and an increase in diurnal proximal sodium reabsorption, without any change in renal haemodynamics or in the modulation of the renin-angiotensin aldosterone system to changes in salt intake. A compensatory increase in brain natriuretic peptide levels was observed. In spite of sodium retention, pioglitazone dissociated the blood-pressure response to salt and abolished salt sensitivity in salt-sensitive individuals.
Conclusions/Interpretation: Pioglitazone increases diurnal proximal sodium retention in diabetic and hypertensive individuals. These effects cause fluid retention and may contribute to the increased incidence of congestive heart failure with glitazones.
Keywords
Clearance, Glitazones, Hormones, Hypertension, Kidney, Sodium, Type 2 Diabetes, Induced Fluid Retention, Body-Fat Distribution, Heart-Failure, Insulin Sensitivity, Controlled-Trial, Rosiglitazone, Thiazolidinediones, Rats
Pubmed
Web of science
Open Access
Yes
Create date
12/07/2010 15:51
Last modification date
25/09/2019 6:08
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