Effect of Lisinopril and Verapamil on Angiopoietin 2 and Endostatin
                    in Hypertensive Diabetic Patients with Nephropathy: A Randomized
                    Trial

Mohamed Salem; Al-Aliaa M. Sallam; Eman Abdel-Aleem; Hala O. El-Mesallamy

doi:10.1055/a-1517-6643

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2021; 53(07): 470-477
DOI: 10.1055/a-1517-6643

Endocrine Care

Effect of Lisinopril and Verapamil on Angiopoietin 2 and Endostatin in Hypertensive Diabetic Patients with Nephropathy: A Randomized Trial

Mohamed Salem

¹Biochemistry Department, Faculty of Pharmacy, Ahram Canadian University, Cairo, Egypt

,

Al-Aliaa M. Sallam‡

²Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

³Biochemistry Department, Badr University in Cairo (BUC), Badr City, Cairo, Egypt

,

Eman Abdel-Aleem

¹Biochemistry Department, Faculty of Pharmacy, Ahram Canadian University, Cairo, Egypt

,

Hala O. El-Mesallamy

²Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

⁴Biochemistry Department, Faculty of Pharmacy, Sinai University, Kantara Branch, Cairo, Egypt

› Author Affiliations

Abstract

Angiogenesis is a multistep process implicated in the pathophysiology and progression of diabetic nephropathy (DN). Angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) have an important role in DN. We performed a randomized-controlled trial of lisinopril alone (an ACEI) or in combination with verapamil (a CCB) as a therapy for DN in type 2 diabetes mellitus (T2DM) patients with hypertension (HTN) and urinary albumin creatinine ratio (UACR) (30–300 mg/g) also to evaluate their effect on UACR, the angiogenic proteins: Angiopoietin 2 (Ang-2) and Endostatin (EST). Forty T2DM patients with microalbuminuria, aged 45–65 years were included. Patients were randomly assigned into group 1 receiving oral lisinopril and group 2 receiving oral lisinopril and verapamil once daily. After 3 months follow-up fasting blood glucose (FPG), HbA1c, lipid profile, UACR, serum urea and creatinine levels were assessed. EST and Ang-2 were measured using ELISA technique. Baseline Ang-2 and EST levels were elevated in both groups compared with controls (p<0.001). After follow-up, group 2 had significantly decreased FPG, HbA1c, UACR, EST and Ang-2 compared with their baseline levels (p<0.001 for all comparisons) and with group 1 (p<0.001). No adverse reactions were reported. Baseline EST and Ang-2 were positively correlated to UACR (r=0.753, p<0.001) (r=0.685, p<0.001). Lisinopril/verapamil combination enhanced glycemic control and kidney function via diminishing EST and Ang-2. This combination can be considered as a safe and effective approach for early stage nephropathy therapy in T2DM.

Key words

diabetic nephropathy - lisinopril - verapamil - angiopoietin - endostatin

Full Text

References

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