Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease

Tina K. Thethi, Muhammad A. Bajwa, Husam Ghanim, Chanhee Jo, Monica Weir, Allison B. Goldfine, Guillermo Umpierrez, Cyrus V Desouza, Paresh Dandona, Ying Fang-Hollingsworth, Vasudevan Raghavan, Vivian A. Fonseca

Research output: Contribution to journalArticle

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Abstract

Aims Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD. Methods A double blind, randomized, placebo-controlled trial was conducted in 60 patients with T2DM and stage 3 or 4 CKD. Paricalcitol 1 mcg or placebo was administered orally once daily for three months. Brachial artery flow mediated dilatation (FMD), nitroglycerine mediated dilation (NMD), and plasma concentrations of inflammatory cytokines, tumor necrosis factor -α and interleukin-6, highly-sensitive C-reactive protein; endothelial surface proteins, intercellular adhesion molecule - 1 and monocyte chemo attractant protein-1, and plasma glucose, insulin, free fatty acids, and urinary isoprostane were measured at baseline and end of three months. Results 27 patients in the paricalcitol group and 28 patients in the control group completed the study, though analysis of FMD at both time points was possible in 23 patients in each group. There was no significant difference in the change in FMD, NMD or the biomarkers examined after paricalcitol or placebo treatment. Conclusions Treatment with paricalcitol at this dose and duration did not affect brachial artery FMD or biomarkers of inflammation and oxidative stress. The lack of significance may be due to the fact that the study patients had advanced CKD and that effects of paricalcitol are not additive to the effects of glycemic, lipid and anti-hypertensive therapies.

Original languageEnglish (US)
Pages (from-to)433-437
Number of pages5
JournalJournal of Diabetes and Its Complications
Volume29
Issue number3
DOIs
StatePublished - Apr 1 2015

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Chronic Renal Insufficiency
Type 2 Diabetes Mellitus
Dilatation
Inflammation
Placebos
Brachial Artery
Nitroglycerin
Oxidative Stress
Biomarkers
Isoprostanes
Intercellular Adhesion Molecule-1
paricalcitol
Double-Blind Method
Nonesterified Fatty Acids
Vitamin D
C-Reactive Protein
Antihypertensive Agents
Blood Proteins
Monocytes
Interleukin-6

Keywords

  • Chronic kidney disease
  • Diabetes mellitus
  • Endothelial dysfunction
  • Inflammation
  • Paricalcitol

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease. / Thethi, Tina K.; Bajwa, Muhammad A.; Ghanim, Husam; Jo, Chanhee; Weir, Monica; Goldfine, Allison B.; Umpierrez, Guillermo; Desouza, Cyrus V; Dandona, Paresh; Fang-Hollingsworth, Ying; Raghavan, Vasudevan; Fonseca, Vivian A.

In: Journal of Diabetes and Its Complications, Vol. 29, No. 3, 01.04.2015, p. 433-437.

Research output: Contribution to journalArticle

Thethi, TK, Bajwa, MA, Ghanim, H, Jo, C, Weir, M, Goldfine, AB, Umpierrez, G, Desouza, CV, Dandona, P, Fang-Hollingsworth, Y, Raghavan, V & Fonseca, VA 2015, 'Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease', Journal of Diabetes and Its Complications, vol. 29, no. 3, pp. 433-437. https://doi.org/10.1016/j.jdiacomp.2015.01.004
Thethi, Tina K. ; Bajwa, Muhammad A. ; Ghanim, Husam ; Jo, Chanhee ; Weir, Monica ; Goldfine, Allison B. ; Umpierrez, Guillermo ; Desouza, Cyrus V ; Dandona, Paresh ; Fang-Hollingsworth, Ying ; Raghavan, Vasudevan ; Fonseca, Vivian A. / Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease. In: Journal of Diabetes and Its Complications. 2015 ; Vol. 29, No. 3. pp. 433-437.
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abstract = "Aims Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD. Methods A double blind, randomized, placebo-controlled trial was conducted in 60 patients with T2DM and stage 3 or 4 CKD. Paricalcitol 1 mcg or placebo was administered orally once daily for three months. Brachial artery flow mediated dilatation (FMD), nitroglycerine mediated dilation (NMD), and plasma concentrations of inflammatory cytokines, tumor necrosis factor -α and interleukin-6, highly-sensitive C-reactive protein; endothelial surface proteins, intercellular adhesion molecule - 1 and monocyte chemo attractant protein-1, and plasma glucose, insulin, free fatty acids, and urinary isoprostane were measured at baseline and end of three months. Results 27 patients in the paricalcitol group and 28 patients in the control group completed the study, though analysis of FMD at both time points was possible in 23 patients in each group. There was no significant difference in the change in FMD, NMD or the biomarkers examined after paricalcitol or placebo treatment. Conclusions Treatment with paricalcitol at this dose and duration did not affect brachial artery FMD or biomarkers of inflammation and oxidative stress. The lack of significance may be due to the fact that the study patients had advanced CKD and that effects of paricalcitol are not additive to the effects of glycemic, lipid and anti-hypertensive therapies.",
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T1 - Effect of paricalcitol on endothelial function and inflammation in type 2 diabetes and chronic kidney disease

AU - Thethi, Tina K.

AU - Bajwa, Muhammad A.

AU - Ghanim, Husam

AU - Jo, Chanhee

AU - Weir, Monica

AU - Goldfine, Allison B.

AU - Umpierrez, Guillermo

AU - Desouza, Cyrus V

AU - Dandona, Paresh

AU - Fang-Hollingsworth, Ying

AU - Raghavan, Vasudevan

AU - Fonseca, Vivian A.

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N2 - Aims Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD. Methods A double blind, randomized, placebo-controlled trial was conducted in 60 patients with T2DM and stage 3 or 4 CKD. Paricalcitol 1 mcg or placebo was administered orally once daily for three months. Brachial artery flow mediated dilatation (FMD), nitroglycerine mediated dilation (NMD), and plasma concentrations of inflammatory cytokines, tumor necrosis factor -α and interleukin-6, highly-sensitive C-reactive protein; endothelial surface proteins, intercellular adhesion molecule - 1 and monocyte chemo attractant protein-1, and plasma glucose, insulin, free fatty acids, and urinary isoprostane were measured at baseline and end of three months. Results 27 patients in the paricalcitol group and 28 patients in the control group completed the study, though analysis of FMD at both time points was possible in 23 patients in each group. There was no significant difference in the change in FMD, NMD or the biomarkers examined after paricalcitol or placebo treatment. Conclusions Treatment with paricalcitol at this dose and duration did not affect brachial artery FMD or biomarkers of inflammation and oxidative stress. The lack of significance may be due to the fact that the study patients had advanced CKD and that effects of paricalcitol are not additive to the effects of glycemic, lipid and anti-hypertensive therapies.

AB - Aims Patients with type 2 diabetes (T2DM) and chronic kidney disease (CKD) have impaired endothelial function. Vitamin D and its analogs may play a role in regulation of endothelial function and inflammation. We studied effects of paricalcitol compared to placebo on endothelial function and markers of inflammation and oxidative stress in patients with T2DM and CKD. Methods A double blind, randomized, placebo-controlled trial was conducted in 60 patients with T2DM and stage 3 or 4 CKD. Paricalcitol 1 mcg or placebo was administered orally once daily for three months. Brachial artery flow mediated dilatation (FMD), nitroglycerine mediated dilation (NMD), and plasma concentrations of inflammatory cytokines, tumor necrosis factor -α and interleukin-6, highly-sensitive C-reactive protein; endothelial surface proteins, intercellular adhesion molecule - 1 and monocyte chemo attractant protein-1, and plasma glucose, insulin, free fatty acids, and urinary isoprostane were measured at baseline and end of three months. Results 27 patients in the paricalcitol group and 28 patients in the control group completed the study, though analysis of FMD at both time points was possible in 23 patients in each group. There was no significant difference in the change in FMD, NMD or the biomarkers examined after paricalcitol or placebo treatment. Conclusions Treatment with paricalcitol at this dose and duration did not affect brachial artery FMD or biomarkers of inflammation and oxidative stress. The lack of significance may be due to the fact that the study patients had advanced CKD and that effects of paricalcitol are not additive to the effects of glycemic, lipid and anti-hypertensive therapies.

KW - Chronic kidney disease

KW - Diabetes mellitus

KW - Endothelial dysfunction

KW - Inflammation

KW - Paricalcitol

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