Department of Endocrinology and Metabolism, Dr Ersin Arslan Training and Research Hospital, Gaziantep, Türkiye.
Department of Internal Medicine, Marmara University Training and Research Hospital, Istanbul, Türkiye.
Minerva Endocrinol (Torino). 2023 Sep;48(3):295-304. doi: 10.23736/S2724-6507.21.03465-5. Epub 2021 May 12.
There are cost-effective, non-invasive, and predictive tools used to predict the CVD risk in patients with diabetes such as the "atherogenic index of plasma (AIP)" which is defined as the logarithm to the base 10 of the ratio of fasting plasma TG (mg/dL) to HDL-C [log (TG/HDL-C)], triglyceride to high density lipoprotein (TG-to-HDL-C) ratio and the triglyceride glucose (TyG) index which is calculated as Ln (fasting TG [mg/dL] × fasting blood glucose (mg/dL)/2). These tools are indirect markers of atherosclerosis. Dapagliflozin and empagliflozin have exhibited cardiovascular beneficial effects and this study evaluated the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on AIP, TyG index and TG-to-HDL-C ratio in patients with type 2 diabetes.
This single center, retrospective, observational study involved patients with type 2 diabetic patients who were prescribed SGLT2i in the endocrinology outpatient clinic between January 2017 and June 2019. Demographic and clinical data were collected from patient files. AIP, TyG index and TG-to-HDL-C ratio were calculated obtained at the first visit and the sixth month visit.
Overall, 143 patients with T2DM (75 women, 68 men) were recruited in this study. Sixty-six patients were prescribed dapagliflozin (46.2%), and 77 were prescribed empagliflozin (53.8%). SGLT2i treatment did not alter the lipid profile except the serum triglyceride (TG) levels. Serum TG levels were significantly reduced after 6 months of SGLT2i therapy (P=0.045). All patients had significant reductions in AIP at 6-month follow-up (P<0.001), accompanied by a significant reduction in TyG index (P<0.001). Both empagliflozin and dapagliflozin caused significant decrease in AIP (P=0.043 and P<0.001, respectively) and TyG index (P=0.010 and P<0.001, respectively).
Both dapagliflozin and empagliflozin were noted to significantly affect AIP and TyG indexes, which indicate atherosclerotic cardiovascular risk, with or without statin treatment regardless of lipid parameters.
有一些经济有效的、非侵入性的、具有预测价值的工具，可用于预测糖尿病患者的 CVD 风险，例如“血浆致动脉粥样硬化指数（AIP）”，其定义为空腹血浆 TG（mg/dL）与 HDL-C[log（TG/HDL-C）]的对数之比、三酰甘油与高密度脂蛋白（TG-to-HDL-C）的比值和三酰甘油葡萄糖（TyG）指数，该指数计算为空腹 TG[mg/dL]×空腹血糖[mg/dL]/2 的自然对数。这些工具是动脉粥样硬化的间接标志物。达格列净和恩格列净已显示出心血管获益，本研究评估了钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）对 2 型糖尿病患者 AIP、TyG 指数和 TG-to-HDL-C 比值的影响。
这是一项单中心、回顾性、观察性研究，纳入了 2017 年 1 月至 2019 年 6 月期间在内分泌科门诊开处 SGLT2i 的 2 型糖尿病患者。从患者病历中收集人口统计学和临床数据。在首次就诊和第六个月就诊时计算并获得 AIP、TyG 指数和 TG-to-HDL-C 比值。
本研究共纳入 143 例 2 型糖尿病患者（75 名女性，68 名男性）。66 例患者服用达格列净（46.2%），77 例患者服用恩格列净（53.8%）。SGLT2i 治疗除了血清三酰甘油（TG）水平外，对血脂谱没有影响。SGLT2i 治疗 6 个月后，血清 TG 水平显著降低（P=0.045）。所有患者在 6 个月随访时 AIP 显著降低（P<0.001），同时 TyG 指数显著降低（P<0.001）。恩格列净和达格列净均可显著降低 AIP（P=0.043 和 P<0.001）和 TyG 指数（P=0.010 和 P<0.001）。
无论是否使用他汀类药物治疗，无论血脂参数如何，达格列净和恩格列净均能显著影响 AIP 和 TyG 指数，这表明存在动脉粥样硬化性心血管风险。
