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Lipid-lowering treatment and inflammatory mediators in diabetes and chronic kidney disease
KTH, Skolan för arkitektur och samhällsbyggnad (ABE), Transportvetenskap, Transport- och lokaliseringsanalys. KTH, Skolan för arkitektur och samhällsbyggnad (ABE), Centra, Centrum för transportstudier, CTS.ORCID-id: 0000-0001-7606-8771
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2014 (Engelska)Ingår i: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 44, nr 3, s. 276-284Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Inflammation may contribute to the high cardiovascular risk in diabetes mellitus (DM) and chronic kidney disease (CKD). Monocyte chemoattractant protein-1 (MCP-1) facilitates the recruitment of monocytes into atherosclerotic lesions and is involved in diabetic nephropathy. Interferon gamma (IFNγ) is important in atherosclerosis and increases the synthesis of chemokines including MCP-1. Lipid-lowering treatment (LLT) with statins may have anti-inflammatory effects, and ezetimibe cotreatment provides additional cholesterol lowering. Methods: After a placebo run-in period, the effects of simvastatin alone (S) or simvastatin + ezetimibe (S+E) were compared in a randomized, double-blind, cross-over study on inflammatory parameters. Eighteen DM patients with estimated glomerular filtration rate (eGFR) 15-59 mL/min × 1·73 m2 (CKD stages 3-4) (DM-CKD) and 21 DM patients with eGFR > 75 mL/min (DM only) were included. Results: At baseline, monocyte chemoattractant protein 1 (MCP-1) (P = 0·03), IFNγ (P = 0·02), tumour necrosis factor-α (TNFα) (P < 0·01) and soluble vascular adhesion molecule (sVCAM) (P = 0·001) levels were elevated in DM-CKD compared with DM-only patients. LLT with S and S+E reduced MCP-1 levels (P < 0·01 by anova) and IFNγ levels (P < 0·01) in DM-CKD patients but not in DM-only patients. Reductions were most pronounced with the combination treatment. Conclusions: DM patients with CKD stages 3-4 had increased inflammatory activity compared with DM patients with normal GFR. Lipid-lowering treatment decreased the levels of MCP-1 and IFNγ in DM patients with concomitant CKD, which may be beneficial with regard to the progression of both atherosclerosis and diabetic nephropathy.

Ort, förlag, år, upplaga, sidor
2014. Vol. 44, nr 3, s. 276-284
Nyckelord [en]
Chronic kidney disease, Diabetes mellitus, Inflammation, Lipid-lowering treatment
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:kth:diva-142342DOI: 10.1111/eci.12230ISI: 000330985500006Scopus ID: 2-s2.0-84893736247OAI: oai:DiVA.org:kth-142342DiVA, id: diva2:699699
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QC 20140228

Tillgänglig från: 2014-02-28 Skapad: 2014-02-28 Senast uppdaterad: 2017-12-05Bibliografiskt granskad

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