Kusunoki Masataka, Sato Daisuke, Sakazaki Takahiko, Miyata Tetsuro, Tsutsumi Kazuhiko, Oshida Yoshiharu
Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan.
Department of Biomedical Information Engineering, Graduate School of Medical Science, Yamagata University, Yamagata, Japan.
Drug Res (Stuttg). 2020 Apr;70(4):131-136. doi: 10.1055/a-1070-8783. Epub 2020 Mar 12.
We conducted this study to determine whether additional administration sodium-glucose co-transporter 2 (SGLT2) inhibitor might provide further improvement of glycemic control and also to explore any advantages in Japanese type 2 diabetes patients showing relatively good glycemic control under treatment dipeptidyl peptidase-4 (DPP-4) inhibitors. We divided the patients in two groups, MT group and CT group. The MT group were continued on the DPP-4 inhibitor treatment for 6-months, and CT group were additionally administered an SGLT2 inhibitor treatment for 6-months. The MT group showed a significant decrease of hemoglobin A1c (HbA1c), but a significant increase of body weight, body mass index and serum uric acid, compared to the baseline values, while the CT group showed a significant decrease of HbA1c, body weight, BMI, and serum uric acid, and also a significant increase of serum HDL-cholesterol and decrease of serum triglyceride levels. Furthermore, this group showed a significant decrease of serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (γ-GTP), which are markers of liver function. These results suggest that the combination therapy is useful, in particular, for the treatment of type 2 diabetes mellitus patients with hyperlipidemia and liver dysfunction. Among the SGLT2 inhibitors added to the DPP-4 inhibitor treatment, the decreases of serum levels of AST, ALT and γ-GTP were particularly significant in the group receiving luseogliflozin, suggesting that the combination of a DPP-4 inhibitor with luseogliflozin is particularly effective for the treatment of type 2 diabetes mellitus patients with liver dysfunction.
我们开展这项研究，以确定额外使用钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂是否能进一步改善血糖控制，并探讨在接受二肽基肽酶-4（DPP-4）抑制剂治疗且血糖控制相对良好的日本2型糖尿病患者中使用该抑制剂是否有任何优势。我们将患者分为两组，即MT组和CT组。MT组继续接受DPP-4抑制剂治疗6个月，CT组额外接受SGLT2抑制剂治疗6个月。与基线值相比，MT组糖化血红蛋白（HbA1c）显著降低，但体重、体重指数和血清尿酸显著升高；而CT组HbA1c、体重、BMI和血清尿酸显著降低，血清高密度脂蛋白胆固醇显著升高，血清甘油三酯水平降低。此外，该组肝功能指标天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和γ-谷氨酰转肽酶（γ-GTP）的血清水平显著降低。这些结果表明，联合治疗尤其对伴有高脂血症和肝功能障碍的2型糖尿病患者有用。在DPP-4抑制剂治疗基础上加用SGLT2抑制剂的患者中，接受鲁格列净治疗的组AST、ALT和γ-GTP血清水平的降低尤为显著，这表明DPP-4抑制剂与鲁格列净联合使用对肝功能障碍的2型糖尿病患者治疗特别有效。
