Effectiveness of Valsartan in Obese Versus Non-Obese Type 2 Diabetic patients presented with microalbuminuria
Muhammad Kashif Khan, Shakeel Khan, Ahmad Shamim Khan, Khawar Sultan, Armughan Ahmad, Usman Khalid
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ABSTRACT
Aim: To ascertain efficacy of Valsartan, an
angiotensin receptor blocker (ARB) in reducing microalbuminuria in obese verses
non obese patients.
Methods: This comparative study was done in Department of Nephrology
Pakistan Institute of Medical Sciences Islamabad from July 1, 2018 to December
31, 1018. Patients fulfilling selection criteria were enrolled and categorized
as two groups obese & non-obese; both groups were given valsartan. Urine
ACR and serum creatinine was followed every month for 6 months.
Results: Average age of all cases as 52.06 ± 4.11
years while the mean age in obese and non-obese cases was 52.48 ± 4.25 years
and 51.63 ± 3.95 years, respectively. The mean change in Urine ACR (from
baseline to 6th months) in obese cases was 41.76 ± 25.81 and
non-obese cases was 76.05 ± 7.63, p-value <0.001. In obese cases mean urine
ACR at 1st and 2nd month was same from baseline, p-value
> 0.05 while at 3rd, 4th month was statistically lower
as compare to baseline urine ACR, p-value < 0.05. Moreover, in non-obese
cases the mean urine ACR was statistically decreased at 1st, 2nd,
3rd, 4th, 5th and 6th month when
compared with baseline, p-value < 0.001.
At 4th month in obese cases none of the cases achieved ACR
< 30 while in non-obese cases 4(7.4%) cases achieved ACR < 30 with
significantly higher frequency in non-obese cases, p-value < 0.05. At 4th
month in obese cases 12(22.2%) cases achieved ACR < 30 while in non-obese
cases 31(57.4%) cases achieved ACR < 30 with significantly higher frequency
in non-obese cases, p-value < 0.001. At 6th month in obese cases
20(37%) cases achieved ACR < 30 while in non-obese cases 41(75.9%) cases
achieved ACR < 30 with significantly higher frequency in non-obese cases,
p-value < 0.001.
Conclusion: Valsartan is
more effective in reducing microalbuminuria in non-obese patients as compared
to obese patients.
Keywords: Diabetes
mellitus, obesity, microalbuminuria, Valsartan