Effect of Angiotensin Receptor Inhibitors on Endothelial Dysfunction

Children and teenager with diabetes type I (IDDM or Insulin dependent diabetes mellitus) are strongly at risk for diabetic nephropathy in adolescents and adulthood. Treatment of endothelial dysfunction can increase the longevity of these patients. The aim of this study was to evaluate the effect of angiotensin receptor blockers (ARBs or Angiotensin receptor blockers) in endothelial dysfunction indices in patients with diabetic nephropathy. This prospective clinical trial study was conducted between 2010 and 2011 in Isfahan, Iran. 32 patients with diabetic nephropathy that their microalbuminuria has been proved in two urine samples were enrolled in the study. All of the studied patients were treated with valsartan (an ARBs medication) for one month. The level of nitric oxide (NO), vascular cell adhesion molecule (VCAM) and Fetuin-A was measured before and after the treatment period. The mean age of patients was 24.66 ± 2.16 years. 34.4% of petients were men. Before the intervention, the level of Fetuin-A was o.36 ± 0.03 mg/dl and after intervention it declined to 0.25 ± 0.02 mg/dl. The mean level of NO before and after the intervention was respectively 0.23 ± 0.01 and 0.29 ± 0.01 mg/dl. The level of VCAM was 0.251 ± 18.5 ng/ml before the intervention and 211.5 ± 11.2 ng/ml after it. The evidence of this showed that the Valsartan medication or other angiotensin receptor inhibitors can be effective can improve endothelial function. Therefore, it is recommended to improve endothelial function of drugs used angiotensin.