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体重减轻对2型糖尿病患者使用钠-葡萄糖协同转运蛋白2抑制剂疗效的影响

Efficacy of Body Weight Reduction on the SGLT2 Inhibitor in People with Type 2 Diabetes Mellitus.

作者信息

Cho Hyun A, Jung Young Lee, Lee Yong Hoon, Lee Yu Chang, Lee Jung Eun, Lee Sol Jae, Jeong Su Jin, Kim Chong Hwa

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Sejong General Hospital, Bucheon, Korea.

出版信息

J Obes Metab Syndr. 2017 Jun;26(2):107-113. doi: 10.7570/jomes.2017.26.2.107. Epub 2017 Jun 30.

Abstract

BACKGROUND

Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia and body weight by inhibiting renal glucose reabsorption. However, only a few studies have demonstrated efficacy of dapagliflozin for type 2 diabetic patients in Korea. We evaluated the efficacy and safety of dapagliflozin for Korean type 2 diabetes patients.

METHODS

This is a retrospective study that included data from 61 patients who received 12 months of dapagliflozin therapy and who visited a single medical center between January 2015 and July 2016. Patients were separated into three groups: dual combination of dapagliflozin and metformin, triple combination of dapagliflozin and metformin with sulfonylurea, or dipeptidyl peptidase IV inhibitors, and quadriple combination of dapagliflozin, metformin, and sulfonylurea with dipeptidyl peptidase IV inhibitors. Patients who achieved ≥5% body weight reduction were classified as responders, and those who achieved <5% body weight reduction were classified as non-responders.

RESULTS

After 12 months, the mean change from baseline body weight was -3.4±2.6 kg (<0.001) for all patients, -3.4±3.1 kg (<0.001) for group 1, -2.7±2.0 kg (=0.008) for group 2, and -4.0±2.3 kg (<0.001) for group 3. Fasting C-peptide level was higher in the responder group than in the non-responder group (3.25±1.07 ng/mL vs. 2.62±1.02 ng/mL, =0.023). In total, reductions in HbA1c, PP2, and FPG levels were -0.61±0.82% (=0.000), -35.4±62 mg/dL (=0.000), and -21.3±56.2 mg/dL (=0.012), respectively. They had mild adverse events included orthostatic dizziness and urinary tract infection.

CONCLUSION

SGLT2 inhibitor improved glycemic control and reduced body weight in a safe manner for patients with type 2 diabetes mellitus.

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,通过抑制肾脏对葡萄糖的重吸收来降低血糖和体重。然而,仅有少数研究证实达格列净对韩国2型糖尿病患者有效。我们评估了达格列净对韩国2型糖尿病患者的疗效和安全性。

方法

这是一项回顾性研究,纳入了2015年1月至2016年7月期间在单一医疗中心接受12个月达格列净治疗的61例患者的数据。患者被分为三组:达格列净与二甲双胍的双联组合、达格列净与二甲双胍及磺脲类药物或二肽基肽酶IV抑制剂的三联组合、达格列净、二甲双胍、磺脲类药物与二肽基肽酶IV抑制剂的四联组合。体重减轻≥5%的患者被分类为反应者,体重减轻<5%的患者被分类为无反应者。

结果

12个月后,所有患者的基线体重平均变化为-3.4±2.6 kg(<0.001),第1组为-3.4±3.1 kg(<0.001),第2组为-2.7±2.0 kg(=0.008),第3组为-4.0±2.3 kg(<0.001)。反应者组的空腹C肽水平高于无反应者组(3.25±1.07 ng/mL对2.62±1.02 ng/mL,=0.023)。总体而言,糖化血红蛋白、餐后2小时血糖和空腹血糖水平的降低分别为-0.61±0.82%(=0.000)、-35.4±62 mg/dL(=0.000)和-21.3±56.2 mg/dL(=0.012)。他们有包括体位性头晕和尿路感染在内的轻度不良事件。

结论

钠-葡萄糖协同转运蛋白2抑制剂以安全的方式改善了2型糖尿病患者的血糖控制并减轻了体重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25c5/6484898/0ae09fb87b48/jomes-26-107f1.jpg

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