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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