Effects of sitagliptin used alone or combined with irbesartan on changes of interlukin-18 in early diabetic nephropathy patients

ZHANG Kun; REN Qiaohua; WU Tao; DU Junwen

Abstract：Ojective To explore the effects of sitagliptin and irbesartan used alone or in combination on levels of serum cystatin C (CysC) and interleukin-18 (IL-18) and twenty-four hours urine albumin emission rate (UAER) in patients with early diabetic nephropathy.Methods Ninty patients with early diabetic nephropathy were randomly divided to three groups, with 30 patients in each group. Based on former treatment and life style, the patients in the sitagliptin group were treated with sitagliptin 100 mg, po, qd; the patients in the irbesartan group were treated with irbesartan 150 mg, po, qd; the patients in the combination therapy group were treated with sitagliptin (100 mg, po, qd) and irbesartan (150 mg, po, qd). All patients in each group received the correlative therapy for 12 weeks. Glycosylated hemoglobin (HbAlc), serum CysC, IL-18 and 24 h urine albumin emission rate (UAER) were measured before and after treatment.Results Compared with those before the treatment, levels of CysC, IL-18 and UAER were significant lower after treatment in three groups (P＜0.05), especially for the combination therapy group (P＜0.05). There was no significant difference between the sitagliptin group and irbesartan group (P＞0.05). The HbAlc level decreased in the sitagliptin group and combination therapy group (P＜0.05) after the treatments, no significant difference between two groups (P＞0.05).Conclusion Sitagliptin used alone or combined with irbesartan can ameliorate blood glucose level and improve renal function ameliorate in patients with early diabetic nephropathy, and the combination therapy is superior to monotherapy. Decline in serum CysC and IL-18 can effectively response the improvement of renal function, and sitagliptin may play a role of renal protection by resisting oxidative stress.