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达格列净对2型糖尿病患者12导联心电图的可能影响

The Possible Effects of Dapagliflozin on 12-derived Electrocardiogram in Patients with Type 2 Diabetes Mellitus.

作者信息

Akkuş Oğuz, Akkuş Gamze, Kaypaklı Onur

机构信息

Department of Cardiology, Mustafa Kemal University, Hatay, Turkey.

Department of Endocrinology and Metabolism, Antakya State Hospital, Hatay, Turkey.

出版信息

Endocr Metab Immune Disord Drug Targets. 2019;19(2):207-213. doi: 10.2174/1871530319666181218121508.

Abstract

BACKGROUND

Dapagliflozin, sodium glucose cotransporter 2 inhibitor, has potential side effects on electrolyte imbalance as it has diuretic effects which include decreasing glucose reabsorption, increasing glucosuria and natriuresis. We aimed to determine the possible effects of dapagliflozin on electrocardiogram (ECG) in patients with type 2 DM.

MATERIAL AND METHODS

This retrospective study consisted of 49 patients (25 female, 24 male). Patients who had inadequate glycemic control besides using several oral antidiabetics, subsequently endorsed with dapagliflozin, were included in the current study.

RESULTS

Meantime interval from treatment initiation to control was 10.5 ± 5.03 weeks. Body mass index, glucose, HbA1C, eGFR, LDL-C, heart rate, systolic and diastolic blood pressures were found to be significantly lower at control admission (p<0.05). Creatinine and QT interval were significantly higher at control admission (p<0.05). Baseline Tpe duration and baseline Tpe/QT ratio were found to be significantly correlated with Tpe/QT difference (p<0.05). In linear regression analysis, baseline Tpe/QT ratio was found to be the sole independent predictor of Tpe/QT difference (p<0.05).

CONCLUSION

Initiation of dapagliflozin treatment seems to be safe, up to several months, in terms of serum electrolytes and ECG findings in patients with type 2 DM with a probable improvement.

摘要

背景

达格列净是一种钠-葡萄糖协同转运蛋白2抑制剂,因其具有利尿作用,包括减少葡萄糖重吸收、增加糖尿和尿钠排泄,可能对电解质平衡产生副作用。我们旨在确定达格列净对2型糖尿病患者心电图(ECG)的可能影响。

材料与方法

这项回顾性研究包括49例患者(25例女性,24例男性)。本研究纳入了除使用多种口服降糖药外血糖控制不佳,随后加用达格列净的患者。

结果

从开始治疗到病情得到控制的平均时间间隔为10.5±5.03周。在病情得到控制时,发现体重指数、血糖、糖化血红蛋白、估算肾小球滤过率、低密度脂蛋白胆固醇、心率、收缩压和舒张压显著降低(p<0.05)。在病情得到控制时,肌酐和QT间期显著升高(p<0.05)。发现基线Tpe持续时间和基线Tpe/QT比值与Tpe/QT差值显著相关(p<0.05)。在线性回归分析中,发现基线Tpe/QT比值是Tpe/QT差值的唯一独立预测因子(p<0.05)。

结论

对于2型糖尿病患者,在几个月内开始使用达格列净治疗在血清电解质和心电图检查结果方面似乎是安全的,且可能有所改善。

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