Double-blind, randomised study of the effect of combined treatment with vitamin C and E on albuminuria in Type 2 diabetic patients

被引:91
作者
Gæde, P
Poulsen, HE
Parving, HH
Pedersen, O
机构
[1] Steno Diabet Ctr, DK-2820 Gentofte, Denmark
[2] Rigshosp, Dept Clin Pharmacol, DK-2200 Copenhagen N, Denmark
关键词
Type; 2; diabetes; albuminuria; vitamin C; vitamin E; kidney function;
D O I
10.1046/j.0742-3071.2001.00574.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Elevated levels of urinary albumin excretion rate (AER) predict high risk for progressing to end-stage renal disease. In streptozotocin-induced diabetes, supplementation with vitamin C or E reduces albuminuria and glomerular hypertrophy. We tested the hypothesis that supplementation of both vitamin C and E in pharmacological doses lowers AER in Type 2 diabetic patients with persistent micro/macroalbuminuria. Methods Thirty Type 2 diabetic patients with AER 30-300 mg/24 h were included in a double-blind randomised, cross-over trial. Patients received vitamin C (1250 mg) and vitamin E (680 IU) per day or matching placebo for 4 weeks with a 3-week wash-out period between treatment periods in random order. Results Combined treatment with vitamin C and E reduced AER by 19% (95% CI 6-34%) (p = 0.04), geometric mean 197 mg/24 h (95% CI 114-341 mg/24 h) vs. 243 mg/24 h (146-404 mg/24 h). No changes were seen in serum creatinine, haemoglobin A(1C) or blood pressure. Fasting plasma concentrations of vitamin C and E increased in all patients during active treatment (mean vitamin C 79.4 mu mol/L (SD 27.8) vs. 41.9 mu mol/L (18.4) and vitamin E 47.0 mu mol/L (19.8) vs. 29.5 mu mol/L (15.3), P < 0.000001). Except for two patients that started additional blood pressure lowering treatment during the run-in period, no changes in medication, food and exercise habits or in the number of smokers occurred during the study. Conclusion Short-term treatment with vitamin C and E in pharmacological doses lowers AER in Type 2 diabetic patients with micro/macroalbuminuria. Further long-term, large-scale studies of this albuminuria reducing treatment modality are warranted.
引用
收藏
页码:756 / 760
页数:5
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