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Elevated serum levels of interleukin-18 in patients with overt diabetic nephropathy: effects of miglitol

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Abstract

Background

Interleukin-18 (IL-18), a pro-inflammatory cytokine, is a predictor of cardiovascular and renal disease in diabetic patients. Postprandial hyperglycemia is one of the important factors contributing to an increase in the circulating pro-inflammatory cytokine levels. This study investigated the effect of miglitol, an α-glucosidase inhibitor, on postprandial hyperglycemia and IL-18 levels in diabetic patients with nephropathy.

Methods

Fifteen Japanese diabetic patients with persistent proteinuria and preserved renal function were recruited. The patients received 50 mg miglitol thrice daily after the baseline examinations and were followed up for 12 weeks. A meal tolerance test was performed on eight patients at baseline and week 12. The fasting miglitol concentration was measured in seven patients just before the meal tolerance test.

Results

There were no changes in the body weight, blood pressure, liver and renal function, and proteinuria from baseline to week 12. However, the levels of glycated hemoglobin and interleukin 18 significantly decreased from baseline to week 12. During the meal tolerance test, plasma glucose was significantly decreased 60 min after treatment with miglitol, whereas the serum concentration of insulin was not changed. Fasting and postprandial levels of IL-18 were significantly decreased from baseline to week 12. Serum miglitol concentrations showed a significantly negative correlation with eGFR (r = −0.82, p = 0.02). However, the serum miglitol concentrations did not changed during the course of this study.

Conclusion

Miglitol improved postprandial hyperglycemia and reduced serum IL-18 levels in patients with stage 3 diabetic nephropathy. Miglitol may therefore prevent atherosclerotic diseases and diabetic micro-vascular complications through decreasing glucose swings and/or the circulating IL-18 level.

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Authors and Affiliations

  1. Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, 520-2192, Japan

    Takashi Uzu, Hiroshi Maegawa, Yukiyo Yokomaku & Shin-ichi Araki

  2. Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Hokkaido, Japan

    Hiroki Yokoyama & Hirofumi Itoh

  3. Division of Diabetes & Endocrinology, Department of Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan

    Daisuke Koya, Atsushi Nakagawa & Makoto Nishizawa

  4. Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan

    Atsuko Abiko & Masakazu Haneda

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  1. Takashi Uzu
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  2. Hiroki Yokoyama
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  3. Hirofumi Itoh
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  11. Masakazu Haneda
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Correspondence to Takashi Uzu.

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Uzu, T., Yokoyama, H., Itoh, H. et al. Elevated serum levels of interleukin-18 in patients with overt diabetic nephropathy: effects of miglitol. Clin Exp Nephrol 15, 58–63 (2011). https://doi.org/10.1007/s10157-010-0343-7

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  • DOI: https://doi.org/10.1007/s10157-010-0343-7

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