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钠-葡萄糖共转运蛋白 2 抑制剂对糖尿病肾病及血清氧化型低密度脂蛋白水平的影响。

The effects of a sodium-glucose cotransporter 2 inhibitor on diabetic nephropathy and serum oxidized low-density lipoprotein levels.

机构信息

Department of Nephrology, Sichuan Mianyang 404 Hospital, Mianyang, China.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Jun;22(12):3994-3999. doi: 10.26355/eurrev_201806_15284.

Abstract

OBJECTIVE

To investigate the effect of an SGLT-2 inhibitor on diabetic nephropathy and serum oxidized low-density lipoprotein (ox-LDL) levels.

PATIENTS AND METHODS

We randomly divided 126 patients with diabetic nephropathy into the treatment group and control group. The 63 patients in the treatment group received an SGLT-2 inhibitor in addition to routine insulin therapy, while the control group received only insulin to control blood glucose. All laboratory indexes were recorded before and after treatment with the SGLT-2 inhibitor. The prognosis of patients was followed-up. Simultaneously, 63 healthy and BMI-matched in-patients were selected as the healthy control group. Peripheral blood samples were collected from all groups, and the levels of ROS were measured by ELISA.

RESULTS

Renal function indexes such as urinary protein, creatinine, blood urea nitrogen, and glomerular filtration rate (GFR) were significantly higher with SGLT-2 inhibitor treatment compared with the control group (p<0.05). The fasting blood glucose level was not significantly increased before or after treatment (p>0.05). The levels of ROS in peripheral blood were significantly lower in the treatment group than in the control group (p<0.05). Observation at the 1-year follow-up showed that the average GFR was significantly higher in the treatment group than in the control group. Furthermore, the proportion of patients with stage 1-3 chronic kidney disease was significantly higher in the treatment group than in the control group (p<0.05).

CONCLUSIONS

The SGLT-2 inhibitor had a good therapeutic effect on renal function in patients with diabetic nephropathy, without having effects on fasting blood glucose. Additionally, it significantly delayed the progression of nephropathy. It is therefore worth clinical promotion.

摘要

目的

研究 SGLT-2 抑制剂对糖尿病肾病及血清氧化型低密度脂蛋白(ox-LDL)水平的影响。

患者与方法

将 126 例糖尿病肾病患者随机分为治疗组和对照组,治疗组在常规胰岛素治疗基础上加用 SGLT-2 抑制剂,对照组仅用胰岛素控制血糖,记录治疗前后所有实验室指标。对患者进行预后随访,同时选取 63 例同期 BMI 匹配的健康住院患者作为健康对照组,采集各组外周血,采用 ELISA 法检测 ROS 水平。

结果

与对照组相比,治疗组患者尿蛋白、肌酐、血尿素氮、肾小球滤过率(GFR)等肾功能指标明显升高(p<0.05),治疗前后空腹血糖水平无明显升高(p>0.05),治疗组外周血 ROS 水平明显低于对照组(p<0.05)。1 年随访观察发现,治疗组平均 GFR 明显高于对照组,且治疗组 1~3 期慢性肾脏病患者比例明显高于对照组(p<0.05)。

结论

SGLT-2 抑制剂对糖尿病肾病患者的肾功能有较好的治疗效果,对空腹血糖无影响,且能显著延缓肾病进展,值得临床推广。

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