Department of Nephrology, Aichi Welfare Cooperative Agricultural Federation, Konan-Kosei Hospital, Konan, Aichi, Japan.
Diab Vasc Dis Res. 2020 Nov-Dec;17(6):1479164120971220. doi: 10.1177/1479164120971220.
Diabetes mellitus is a progressive disease with cardiovascular complications. We evaluated the impact of a glucagon like peptide-1 (GLP-1) receptor agonist and sodium glucose cotransporter 2 (SGLT-2) inhibitors dapagliflozin and empagliflozin on renal and cardiac function in type 2 diabetes patients with renal impairment.
A total of 156 patients referred with suboptimal glycemic control were assigned to Group G (GLP-1): = 72 or Group S (SGLT-2 inhibitor)-dapagliflozin ( = 52) or empagliflozin ( = 32). Renal function was assessed every 3 months for 36 months. Cardiovascular parameters were evaluated every 12 months for 36 months.
Compared with baseline, HbA1c and systolic blood pressure significantly decreased in both groups ( < 0.05). The estimated glomerular filtration rate decreased, but without significance. Albuminuria decreased significantly in both groups and then subsequently increased after 30 months in Group S. Diastolic cardiac function, assessed by E/e' or left atrial volume index, decreased only in Group G at 36 months.
The GLP-1 receptor agonist and SGLT-2 inhibitors were effective for glycemic and blood pressure control and for maintaining renal function. The GLP-1 receptor agonist improved diastolic function at 36 months.
糖尿病是一种进展性疾病，伴有心血管并发症。我们评估了胰高血糖素样肽-1（GLP-1）受体激动剂和钠-葡萄糖共转运蛋白 2（SGLT-2）抑制剂达格列净和恩格列净对伴有肾功能损害的 2 型糖尿病患者的肾脏和心脏功能的影响。
共有 156 名因血糖控制不佳而就诊的患者被分配到 G 组（GLP-1）：n = 72 或 S 组（SGLT-2 抑制剂）-达格列净（n = 52）或恩格列净（n = 32）。肾功能每 3 个月评估一次，共 36 个月。心血管参数每 12 个月评估一次，共 36 个月。
与基线相比，两组的 HbA1c 和收缩压均显著降低（<0.05）。估算的肾小球滤过率下降，但无统计学意义。两组的蛋白尿均显著减少，随后在 S 组 30 个月后再次增加。只有 G 组在 36 个月时舒张性心脏功能（通过 E/e'或左心房容积指数评估）下降。
GLP-1 受体激动剂和 SGLT-2 抑制剂对血糖和血压控制以及维持肾功能有效。GLP-1 受体激动剂在 36 个月时改善了舒张功能。
