Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Diabet Med. 2022 Jan;39(1):e14659. doi: 10.1111/dme.14659. Epub 2021 Aug 2.
The aim of this cross-sectional study is to compare creatinine-based estimated glomerular filtration rate (eGFRcr) and cystatin C-based estimated glomerular filtration rate (eGFRcys) between patients with type 2 diabetes receiving and not receiving sodium-glucose cotransporter 2 (SGLT2) inhibitors.
The plasma specimens from 90 patients with type 2 diabetes who had been receiving SGLT2 inhibitors for at least 24 weeks (SGLT2 inhibitors group) were selected. Meanwhile, the plasma specimens from age-, sex- and BMI-matched patients with type 2 diabetes not receiving SGLT2 inhibitors (non-SGLT2 inhibitors group) in 1:1 matching were also selected for comparison. eGFRcr and eGFRcys were calculated using the Chronic Kidney Disease Epidemiology Collaboration equation.
When compared with the non-SGLT2 inhibitors group, eGFRcr was significantly higher in the SGLT2 inhibitors group (70.54 ± 24.87 vs. 79.95 ± 19.57 mL/min/1.73 m , p = 0.014) while eGFRcys was not different (66.32 ± 24.98 vs 69.17 ± 20.10 ml/min/1.73 m , p = 0.401). Based on eGFRcr, the chronic kidney disease (CKD) stage in the SGLT2 inhibitors group was lower than that in the non-SGLT2 inhibitors group, but it was not different when CKD stage was classified by eGFRcys. The difference between eGFRcr and eGFRcys (eGFRcr-cys) was significantly higher in the SGLT2 inhibitors group (4.22 ± 11.20 vs. 10.78 ± 10.42 ml/min/1.73 m , p < 0.001). In male patients, there was significant correlation between the eGFRcr-cys and duration of receiving SGLT-2 inhibitors (r = 0.398, p = 0.004). This correlation was not found in female patients.
There was a discrepancy between eGFRcr and eGFRcys in patients with type 2 diabetes receiving SGLT2 inhibitors when compared with those not receiving SGLT2 inhibitors.
本横断面研究旨在比较接受和未接受钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂的 2 型糖尿病患者的基于肌酐的估计肾小球滤过率（eGFRcr）和基于胱抑素 C 的估计肾小球滤过率（eGFRcys）。
选择 90 例已接受 SGLT2 抑制剂治疗至少 24 周的 2 型糖尿病患者的血浆标本（SGLT2 抑制剂组），同时选择年龄、性别和 BMI 匹配的 1：1 未接受 SGLT2 抑制剂的 2 型糖尿病患者的血浆标本作为对照（非 SGLT2 抑制剂组）。使用慢性肾脏病流行病学合作方程计算 eGFRcr 和 eGFRcys。
与非 SGLT2 抑制剂组相比，SGLT2 抑制剂组的 eGFRcr 显著升高（70.54 ± 24.87 比 79.95 ± 19.57 ml/min/1.73 m ，p = 0.014），而 eGFRcys 无差异（66.32 ± 24.98 比 69.17 ± 20.10 ml/min/1.73 m ，p = 0.401）。基于 eGFRcr，SGLT2 抑制剂组的慢性肾脏病（CKD）分期低于非 SGLT2 抑制剂组，但基于 eGFRcys 分类时则无差异。SGLT2 抑制剂组的 eGFRcr 与 eGFRcys 之间的差值（eGFRcr-cys）显著高于非 SGLT2 抑制剂组（4.22 ± 11.20 比 10.78 ± 10.42 ml/min/1.73 m ，p < 0.001）。在男性患者中，eGFRcr-cys 与接受 SGLT-2 抑制剂的时间呈显著相关性（r = 0.398，p = 0.004）。在女性患者中则未发现这种相关性。
与未接受 SGLT2 抑制剂的患者相比，接受 SGLT2 抑制剂的 2 型糖尿病患者的 eGFRcr 和 eGFRcys 之间存在差异。
