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达格列净急性改善 2 型糖尿病患者的肾功能。PRECARE 研究。

Dapagliflozin acutely improves kidney function in type 2 diabetes mellitus. The PRECARE study.

机构信息

Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy; Centre for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, DIBIC, Università Degli Studi Milano, Milan, Italy.

Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy.

出版信息

Pharmacol Res. 2022 Sep;183:106374. doi: 10.1016/j.phrs.2022.106374. Epub 2022 Jul 28.

Abstract

Dapagliflozin has been demonstrated to improve glycemic control, blood pressure, and body weight in type 2 diabetes mellitus (T2D); indeed, it can also reduce the risk of progression to renal failure, of hospitalization for heart failure and of cardiovascular death. We aim to investigate the acute effect of Dapagliflozin on kidney function in the common clinical practice in T2D. This is a study including 1402 patients with T2D recruited from 11 centers in Lombardia, Italy, who were evaluated at baseline and after 6 months of treatment with Dapagliflozin 10 mg per day. The primary outcome of the study was the change in HbA1c, while the secondary outcomes were modification of weight, BMI, systolic and diastolic pressure, creatinine, eGFR and albuminuria status. After 24 weeks of treatment with Dapagliflozin, a reduction in Hb1Ac was observed (-0.6 ± 1.8%) as well as in BMI (-1.5 ± 5.2 kg/m). Statistically significant changes were also found for systolic and diastolic blood pressure, cholesterol and triglycerides. Interestingly, a statistically significant acute improvement of kidney function was evident. Our analyses confirm the beneficial effects of dapagliflozin after 6 months of therapy, with improvements of glycemic and lipid profiles, blood pressure, BMI. Finally, an acute positive effect on albuminuria and KIDGO classes was observed during a 6 months treatment with dapagliflozin in patients with T2D.

摘要

达格列净已被证明可改善 2 型糖尿病(T2D)患者的血糖控制、血压和体重;事实上,它还可以降低肾功能衰竭、心力衰竭住院和心血管死亡的风险。我们旨在研究达格列净在 T2D 常见临床实践中的急性肾功能影响。这是一项包括来自意大利伦巴第大区 11 个中心的 1402 名 T2D 患者的研究,这些患者在基线时和接受达格列净 10mg/天治疗 6 个月后进行了评估。该研究的主要结局是 HbA1c 的变化,次要结局是体重、BMI、收缩压和舒张压、肌酐、eGFR 和蛋白尿状态的变化。在接受达格列净治疗 24 周后,Hb1Ac 降低(-0.6±1.8%),BMI 降低(-1.5±5.2kg/m)。收缩压和舒张压、胆固醇和甘油三酯也有统计学显著变化。有趣的是,肾功能的急性改善具有统计学意义。我们的分析证实了达格列净在 6 个月治疗后的有益作用,可改善血糖和血脂谱、血压、BMI。最后,在接受达格列净治疗 6 个月期间,T2D 患者的蛋白尿和 KIDGO 分级出现了急性的积极影响。

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