Kong Sung Hye, Koo Bo Kyung, Moon Min Kyong
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Diabetes Metab J. 2019 Oct;43(5):711-717. doi: 10.4093/dmj.2018.0208. Epub 2019 Mar 20.
The study aimed to evaluate the effects of dapagliflozin and metformin on vascular endothelial function and renal injury markers.
This prospective, randomized, open-label, crossover study included drug-naïve patients with type 2 diabetes mellitus, who were randomized to receive 8 weeks of initial treatment using metformin or dapagliflozin and crossed over for another 8 weeks of treatment after a 1-week washout period. Systemic endothelial function was evaluated via the reactive hyperemic index (RHI).
The 22 participants included 10 males (45.5%) and had a median age of 58 years. The RHI values were not significantly changed during both 8-week treatment periods and there was no significant difference between the treatments. Relative to the metformin group, 8 weeks of dapagliflozin treatment produced significantly higher median -acetyl-beta-D-glucosaminidase levels (10.0 ng/mL [interquartile range (IQR), 6.8 to 12.1 ng/mL] vs. 5.6 ng/mL [IQR, 3.8 to 8.0 ng/mL], =0.013). Only the dapagliflozin group exhibited improved homeostatic model assessment of insulin resistance and body weight, while serum ketone and β-hydroxybutyrate levels increased.
Dapagliflozin treatment did not affect systemic endothelial function or renal injury markers except -acetyl-beta-D-glucosaminidase.
本研究旨在评估达格列净和二甲双胍对血管内皮功能及肾损伤标志物的影响。
这项前瞻性、随机、开放标签、交叉研究纳入了初治的2型糖尿病患者,他们被随机分为接受8周的二甲双胍或达格列净初始治疗组,在1周的洗脱期后交叉接受另外8周的治疗。通过反应性充血指数(RHI)评估全身内皮功能。
22名参与者包括10名男性(45.5%),中位年龄为58岁。在两个8周治疗期内,RHI值均无显著变化,且治疗组间无显著差异。与二甲双胍组相比,达格列净治疗8周产生的中位N-乙酰-β-D-氨基葡萄糖苷酶水平显著更高(10.0 ng/mL[四分位间距(IQR),6.8至12.1 ng/mL]对5.6 ng/mL[IQR,3.8至8.0 ng/mL],P=0.013)。只有达格列净组的胰岛素抵抗稳态模型评估和体重得到改善,而血清酮和β-羟基丁酸水平升高。
达格列净治疗除了对N-乙酰-β-D-氨基葡萄糖苷酶外,不影响全身内皮功能或肾损伤标志物。