Plasma BNP Levels in the Treatment of Type 2 Diabetes with Pioglitazone

Susumu Ogawa, Kazuhisa Takeuchi and Sadayoshi Ito

Division of Nephrology, Endocrinology and Vascular Biology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan

Address correspondence to: Kazuhisa Takeuchi, M.D., Tohoku University School of Medicine, The Second Department of Internal Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan. E-mail: hek293{at}mail.cc.tohoku.ac.jp

Abstract

We monitored the change in plasma ANP and BNP levels (as markers for left ventricular dysfunction (LVD)) in DM2 patients treated with pioglitazone (Pio) for 4 weeks. Thirty DM2 patients with no sign of heart failure were treated with Pio (15 mg/day), and their plasma ANP (normal levels <=43 pg/ml) and BNP levels (normal levels <=18.4 pg/ml) were examined. We also examined those levels in no drug-treatment group (n = 10) as well as buformine treatment group (n = 10). Among these groups, there were no significant differences in clinical profiles related to DM control. Pio treatment was terminated when BNP (above 100 pg/ml) and ANP levels (above 50 pg/ml) suggested the left ventricular dysfunction (LVD). The patients (n = 12) whose BNP levels reached to the LVD-positive levels showed the basal BNP levels above the normal upper limit (18 pg/ml), while the rest of subjects (n = 18) whose basal BNP levels within normal limits did not showed the LVD-positive levels in the Pio-treatment. On the other hand basal ANP levels did not predict the development to LVD. In conclusion, BNP levels are suggested to be a good marker of Pio-induced LVD, and the Pio treatment of DM2 patients with BNP levels above the normal limit should be carefully carried out by monitoring BNP levels.







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