Takenaka Tsuneo, Kishimoto Miyako, Ohta Mari, Tomonaga Osamu, Suzuki Hiromichi
1 Department of Medicine, International University of Health and Welfare, Clinical Research Center, Sanno Hospital, Tokyo, Japan.
2 Tomonaga Clinic, Tokyo, Japan.
Diab Vasc Dis Res. 2017 May;14(3):258-261. doi: 10.1177/1479164117690299. Epub 2017 Feb 1.
The effects of sodium-glucose co-transporter type 2 inhibitors on home blood pressure were examined in type 2 diabetes with nephropathy.
The patients with diabetic nephropathy were screened from medical records in our hospitals. Among them, 52 patients who measured home blood pressure and started to take sodium-glucose co-transporter type 2 inhibitors were selected. Clinical parameters including estimated glomerular filtration rate, albuminuria and home blood pressure for 6 months were analysed.
Sodium-glucose co-transporter type 2 inhibitors (luseogliflozin 5 mg/day or canagliflozin 100 mg/day) reduced body weight, HbA1c, albuminuria, estimated glomerular filtration rate and office blood pressure. Although sodium-glucose co-transporter type 2 inhibitors did not alter morning blood pressure, it reduced evening systolic blood pressure. Regression analyses revealed that decreases in evening blood pressure predicted decrements in albuminuria.
The present data suggest that sodium-glucose co-transporter type 2 inhibitors suppress sodium overload during daytime to reduce evening blood pressure and albuminuria.
在2型糖尿病肾病患者中研究了2型钠-葡萄糖协同转运蛋白抑制剂对家庭血压的影响。
从我们医院的病历中筛选出糖尿病肾病患者。其中，选择了52例测量家庭血压并开始服用2型钠-葡萄糖协同转运蛋白抑制剂的患者。分析了包括估计肾小球滤过率、蛋白尿和6个月家庭血压在内的临床参数。
2型钠-葡萄糖协同转运蛋白抑制剂（鲁格列净5毫克/天或卡格列净100毫克/天）可降低体重、糖化血红蛋白、蛋白尿、估计肾小球滤过率和诊室血压。虽然2型钠-葡萄糖协同转运蛋白抑制剂未改变早晨血压，但降低了夜间收缩压。回归分析显示，夜间血压降低预示着蛋白尿减少。
目前的数据表明，2型钠-葡萄糖协同转运蛋白抑制剂可抑制白天的钠过载，从而降低夜间血压和蛋白尿。
