Department of Diabetes and Endocrinology, Kansai-Rosai Hospital, Amagasaki City, Hyogo, Japan.
Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
J Diabetes Investig. 2024 Jul;15(7):843-850. doi: 10.1111/jdi.14179. Epub 2024 Mar 8.
AIMS/INTRODUCTION: We aimed to evaluate factors that influence changes in blood low-density lipoprotein cholesterol (LDL-C) levels after treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors in Japanese patients with type 2 diabetes.
We retrospectively analyzed clinical data of outpatients newly initiated on SGLT2 inhibitors (n = 176) and other oral antidiabetic drugs (n = 227). The patients were classified into four subgroups according to statin administration and baseline LDL-C levels (<120 or ≥120 mg/dL). Clinical characteristics were compared among the subgroups. Multivariate analysis was carried out to identify factors contributing to changes in LDL-C.
The median follow-up period was 13.0 weeks (range 11.9-14.1 weeks, min 8 weeks, maximum 16 weeks) in the SGLT2i group, and 12.0 weeks (range 10.0-14.0 weeks, min 8 weeks, maximum 16 weeks) in the control group. Both groups showed a significant decrease in LDL-C (SGLT2i group -3.8 ± 24.7 mg/dL, control group -3.4 ± 15.0 mg/dL). Multivariate regression analyses showed that in both groups, the change in LDL-C depended on statin use and baseline LDL-C levels. Stratified analyses showed that LDL-C level was significantly decreased in statin users with baseline LDL-C ≥120 mg/dL (from 148.9 ± 33.5 to 109.3 ± 17.9 mg/dL, P = 0.002), and significantly increased in statin non-users with baseline LDL-C <120 mg/dL (from 96.3 ± 27.3 to 104.7 ± 24.8 mg/dL, P = 0.002). These changes were more characteristic for SGLT2 inhibitors than for other oral antidiabetic drugs (P for interaction = 0.010 and <0.001, respectively).
LDL-C levels and statin medication at baseline influence changes in LDL-C after SGLT2 inhibitors treatment in Japanese patients with type 2 diabetes.
目的/引言：我们旨在评估日本 2 型糖尿病患者接受钠-葡萄糖共转运蛋白 2（SGLT2）抑制剂治疗后，血低密度脂蛋白胆固醇（LDL-C）水平变化的影响因素。
我们回顾性分析了新开始接受 SGLT2 抑制剂（n=176）和其他口服降糖药（n=227）治疗的门诊患者的临床数据。根据他汀类药物的使用和基线 LDL-C 水平（<120 或≥120mg/dL）将患者分为四组。比较各组之间的临床特征。进行多变量分析以确定导致 LDL-C 变化的因素。
SGLT2i 组的中位随访时间为 13.0 周（范围 11.9-14.1 周，最小 8 周，最大 16 周），对照组为 12.0 周（范围 10.0-14.0 周，最小 8 周，最大 16 周）。两组患者的 LDL-C 均显著降低（SGLT2i 组-3.8±24.7mg/dL，对照组-3.4±15.0mg/dL）。多变量回归分析显示，在两组中，LDL-C 的变化取决于他汀类药物的使用和基线 LDL-C 水平。分层分析显示，基线 LDL-C≥120mg/dL 的他汀类药物使用者的 LDL-C 水平显著降低（从 148.9±33.5mg/dL 降至 109.3±17.9mg/dL，P=0.002），而基线 LDL-C<120mg/dL 的他汀类药物非使用者的 LDL-C 水平显著升高（从 96.3±27.3mg/dL 升至 104.7±24.8mg/dL，P<0.001）。与其他口服降糖药相比，这些变化在 SGLT2 抑制剂中更为明显（P 交互=0.010 和<0.001）。
日本 2 型糖尿病患者接受 SGLT2 抑制剂治疗后，基线时的 LDL-C 水平和他汀类药物治疗对 LDL-C 的变化有影响。
