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2型糖尿病患者葡萄糖排泄肾阈值的特征及影响因素

Characteristics and Impact Factors of Renal Threshold for Glucose Excretion in Patients with Type 2 Diabetes Mellitus.

作者信息

Yue Xiao Dan, Wang Jing Yu, Zhang Xin Rong, Yang Ju Hong, Shan Chun Yan, Zheng Miao Yan, Ren Hui Zhu, Zhang Yi, Yang Shao Hua, Guo Zhen Hong, Chang Bai, Chang Bao Cheng

机构信息

Key Laboratory of Hormones and Development, Ministry of Health, Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital, and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.

出版信息

J Korean Med Sci. 2017 Apr;32(4):621-627. doi: 10.3346/jkms.2017.32.4.621.

Abstract

Sodium glucose co-transporter 2 (SGLT-2) inhibitors are newly developed but promising medicine for type 2 diabetes. However, patients with a different renal threshold for glucose excretion (RT(G)) may have a different reaction to this medicine. Therefore, the objective of this study was to investigate the characteristics of RT(G) and its impact factors in patients with type 2 diabetes mellitus (T2DM). The clinical and laboratory data of 36 healthy individuals and 168 in-hospital patients with T2DM were collected and analyzed, RT(G) was calculated using blood glucose (BG) measured by dynamic BG monitoring, urinary glucose excretion (UGE) and estimated glomerular filtration rate (eGFR). The characteristics of RT(G) were investigated. The risk factors for high RT(G) were analyzed using non-conditional logistic regression analysis. Our results found that RT(G) of the T2DM group was higher than that of the healthy individuals (P < 0.05); and 22.22% from the healthy individuals group but 58.33% from the T2DM group had high RT(G). Age, duration of diabetes, body mass index (BMI), and homeostasis model assessment insulin resistance index (HOMA-IR) were independently associated with high RT(G) (P < 0.05). Further stratified analysis revealed that RT(G) in T2DM patients increased with age, duration of diabetes, and BMI. In conclusion, RT(G) is increased in patients with T2DM, especially in those with longer diabetic duration, higher BMI, and those who are older. Therefore, these patients may be more sensitive to SGLT-2 inhibitors.

摘要

钠葡萄糖协同转运蛋白2(SGLT - 2)抑制剂是新开发的但很有前景的2型糖尿病治疗药物。然而,葡萄糖排泄肾阈值(RT(G))不同的患者对这种药物可能有不同反应。因此,本研究的目的是调查2型糖尿病(T2DM)患者RT(G)的特征及其影响因素。收集并分析了36名健康个体和168名住院T2DM患者的临床和实验室数据,使用动态血糖监测测得的血糖(BG)、尿葡萄糖排泄量(UGE)和估算肾小球滤过率(eGFR)计算RT(G)。研究了RT(G)的特征。采用非条件逻辑回归分析高RT(G)的危险因素。我们的结果发现,T2DM组的RT(G)高于健康个体(P < 0.05);健康个体组中有22.22%但T2DM组中有58.33%的患者有高RT(G)。年龄、糖尿病病程、体重指数(BMI)和稳态模型评估胰岛素抵抗指数(HOMA - IR)与高RT(G)独立相关(P < 0.05)。进一步的分层分析显示,T2DM患者的RT(G)随年龄、糖尿病病程和BMI增加。总之,T2DM患者的RT(G)升高,尤其是糖尿病病程较长、BMI较高和年龄较大的患者。因此,这些患者可能对SGLT - 2抑制剂更敏感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/368a/5334160/e99362a3eb1d/jkms-32-621-g001.jpg

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