Ohashi Naro, Aoki Taro, Matsuyama Takashi, Ishigaki Sayaka, Isobe Shinsuke, Fujikura Tomoyuki, Hashimoto Takuya, Tsuriya Daisuke, Morita Hiroshi, Kato Akihiko, Yasuda Hideo
Department of Internal Medicine 1, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Blood Purification Unit, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
Med Sci Monit. 2020 Oct 2;26:e926086. doi: 10.12659/MSM.926086.
BACKGROUND Sodium-glucose cotransporter-2 (SGLT2) inhibitors are new antihyperglycemic drugs for type 2 diabetes. SGLT2 inhibitors ameliorate cardiovascular morbidity and mortality as well as kidney disease progression by reducing body weight (BW), blood pressure (BP), visceral adiposity, albuminuria, and serum uric acid and blood glucose levels. However, it is not clear which effects are pronounced, and what mechanisms are associated with these effects. MATERIAL AND METHODS This study recruited patients with type 2 diabetes who were prescribed an SGLT2 inhibitor for the first time in our outpatient department. Clinical parameters were measured before and 6 months after the administration of the SGLT2 inhibitor, without the addition of new drugs and dose changes for all prescribed drugs. RESULTS This study recruited 24 patients with type 2 diabetes. No significant differences in BP, glycated hemoglobin (HbA1c) levels, and low-density lipoprotein cholesterol levels were observed after SGLT2 inhibitor administration. In contrast, BW and serum uric acid levels decreased significantly, and the fractional excretion of uric acid (FEUA) increased significantly after administration. While no significant relationships were observed between serum uric acid and FEUA with respect to the percentage changes from baseline values, the percentage changes in serum uric acid levels from baseline were significantly and positively associated with those in serum creatinine levels. CONCLUSIONS Serum uric acid levels were immediately decreased owing to the administration of SGLT2 inhibitor, but BP, blood glucose, and serum lipid levels were unchanged. These changes in serum uric acid levels may be associated with changes in renal function.
背景 钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂是用于2型糖尿病的新型降糖药物。SGLT2抑制剂通过降低体重(BW)、血压(BP)、内脏脂肪、蛋白尿、血清尿酸和血糖水平来改善心血管疾病的发病率和死亡率以及肾脏疾病进展。然而,尚不清楚哪些作用更为显著,以及这些作用相关的机制是什么。
材料与方法 本研究招募了在我院门诊首次开具SGLT2抑制剂的2型糖尿病患者。在给予SGLT2抑制剂之前和之后6个月测量临床参数,所有已开具药物均未添加新药且未改变剂量。
结果 本研究招募了24例2型糖尿病患者。给予SGLT2抑制剂后,血压、糖化血红蛋白(HbA1c)水平和低密度脂蛋白胆固醇水平未观察到显著差异。相比之下,给药后体重和血清尿酸水平显著降低,尿酸分数排泄(FEUA)显著增加。虽然血清尿酸和FEUA相对于基线值的百分比变化之间未观察到显著关系,但血清尿酸水平相对于基线的百分比变化与血清肌酐水平的百分比变化显著正相关。
结论 给予SGLT2抑制剂后血清尿酸水平立即降低,但血压、血糖和血脂水平未改变。血清尿酸水平的这些变化可能与肾功能变化有关。