Objectives: The progression of diabetic nephropathy (DN) is highly associated with proteinuria and bone mineral density (BMD). This study aimed to evaluate the efficacy of oral calcitriol on proteinuria and BMD in DN patients. Methods: In this 12-week, prospective, randomized controlled study, we randomly assigned 60 patients with nephropathy due to type 2 diabetic mellitus (T2DM) to receive calcitriol (0.25 mu g/d) or placebo (control) added to the standard treatment. The outcome was determined by changes of urinary albumin-to-creatinine ratio (ACR) and BMD after 12 weeks of treatment in both groups. Results: The baseline characteristics such as age, sex distribution, and BMI in the two groups were similar. Compared with pre-calcitriol treatment group, levels of fasting plasma glucose, fasting insulin, glycosylated hemoglobin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, homeostasis model of assessment for insulin resistance index, and ACR in the patients of post-calcitriol treatment were significantly reduced, whereas high-density lipoprotein cholesterol was elevated markedly. The difference was statistically significant (P< 0.05). However, there were no statistical differences between pre-placebo treatment and post-placebo treatment group (P> 0.05). Besides, serum creatinine did not differ significantly after treatment with placebo or calcitriol (P> 0.05). Furthermore, oral calcitriol significantly increased serum osteocalcin concentrations and BMD of lumbar spine and femoral shaft (P< 0.05), whereas the difference of femoral neck BMD had no statistical significance (P> 0.05). Conclusion: Oral calcitriol treatment may improve glucose and lipid metabolism, ameliorate proteinuria as evaluated by reduced ACR level, and improve BMD in type 2 DN patients.
[1]Fudan Univ, Jinshan Hosp, Dept Endocrinol, 1508 Long Hang Rd, Shanghai 201508, Peoples R China.
(8.0+极速模式)