Higashikawa Toshihiro, Ito Tomohiko, Mizuno Takurou, Ishigami Keiichiro, Kohori Masaru, Mae Kunihiro, Usuda Daisuke, Takeshima Kento, Takagi Susumu, Izumida Toshihide, Yamada Shinya, Kuroki Kengo, Sangen Ryusho, Saito Atsushi, Iguchi Masaharu, Kamasaki Yuji, Nakahashi Takeshi, Fukuda Akihiro, Kanda Tsugiyasu, Okuro Masashi
Kanazawa Medical University Himi Municipal Hospital, 1130, Kurakawa, Himi, Toyama 935-8531, Japan.
Department of Geriatric Medicine, Kanazawa Medical University, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan.
J Clin Med Res. 2020 Aug;12(8):530-538. doi: 10.14740/jocmr4278. Epub 2020 Jul 22.
Patients with type 2 diabetes mellitus (T2DM) are at increased risk for impairment in heart failure and diastolic relaxation while preserving ejection fraction (EF). Recently, several sodium glucose cotransporter-2 (SGLT2) inhibitors have demonstrated to decrease cardiovascular disease (CVD) events in elderly diabetic patients, although gender difference in the effect of SGLT2 inhibitors is unknown. The objective of the present study was to evaluate gender difference in the effect of tofogliflozin, one of the SGLT2 inhibitors, on CVD function in patients with diabetes mellitus.
This was a retrospective study. Patients received 20 mg of tofogliflozin daily for 3 months. EF, ratio of early filling to atrial filling (E/A), a change in mitral inflow E and mitral e' annular velocities (E/e'), left atrial dimension (LAD) and maximal diameter of inferior vena cava (IVC), including various physiological parameters were measured between baseline, 1 month and 3 months after administration of tofogliflozin. Interaction between gender and time after administration was evaluated using mixed effect model.
The results showed significant decrease in E/e' (P < 0.01) and significant interaction between time and gender in E/A (P < 0.01), following administration of tofogliflozin for 3 months. EF was constantly higher significantly in women (P < 0.01).
It is concluded that 3-month administration of tofogliflozin decreased E/e' with gender difference in EF and E/A.
2型糖尿病（T2DM）患者在射血分数（EF）保留的情况下，发生心力衰竭和舒张功能障碍的风险增加。最近，几种钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂已被证明可降低老年糖尿病患者的心血管疾病（CVD）事件，尽管SGLT2抑制剂作用的性别差异尚不清楚。本研究的目的是评估SGLT2抑制剂之一的托格列净对糖尿病患者心血管功能影响的性别差异。
这是一项回顾性研究。患者每天服用20 mg托格列净，持续3个月。在服用托格列净的基线、1个月和3个月后，测量EF、早期充盈与心房充盈的比值（E/A）、二尖瓣流入E峰和二尖瓣环e'峰速度的变化（E/e'）、左心房内径（LAD）和下腔静脉最大直径（IVC），包括各种生理参数。使用混合效应模型评估性别与给药后时间之间的相互作用。
结果显示，服用托格列净3个月后，E/e'显著降低（P < 0.01），E/A在时间和性别之间存在显著相互作用（P < 0.01）。女性的EF持续显著更高（P < 0.01）。
得出的结论是，服用托格列净3个月可降低E/e'，且在EF和E/A方面存在性别差异。
