Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Kufa, Kufa, Iraq.
J Med Life. 2024 May;17(5):530-535. doi: 10.25122/jml-2023-0301.
Diabetes mellitus is a major public health concern, often leading to undiagnosed micro- and macrovascular complications, even in patients with controlled blood glucose levels. Recent evidence suggests that empagliflozin and metformin have renoprotective effects in addition to their hypoglycemic action. This study investigated the potential protective effect of empagliflozin and metformin on diabetic renal complications. Forty-two adult male Sprague Dawley rats were randomized into six groups: normal control, diabetic control, metformin (250 mg/kg), empagliflozin (10 mg/kg), and combination therapy groups. Type 2 diabetes was induced in rats by a single intraperitoneal injection of streptozotocin (40 mg/kg) following two weeks of 10% fructose solution in their drinking water. Blood glucose, creatinine, urea nitrogen, inflammatory markers (IL-6, TNF-α), and renal tissue caspase-3 were assessed after eight weeks. Blood glucose, urea, creatinine, serum IL-6, TNF-α, and tissue caspase-3 were significantly decreased in the treatment groups compared to the diabetic group. The histopathological findings revealed that treatment with empagliflozin and/or metformin improved the damage in the renal tissue caused by diabetes-induced nephropathy. Moreover, co-administration of empagliflozin and metformin resulted in even better outcomes. Our data revealed that empagliflozin and metformin could improve renal function and decrease inflammation and apoptosis in diabetic animals, delaying the progression of diabetic nephropathy. Combined treatment with metformin and empagliflozin proved to have an additive protective action on renal tissue.
糖尿病是一个主要的公共卫生关注点，即使在血糖控制良好的患者中，也常常导致未诊断的微血管和大血管并发症。最近的证据表明，恩格列净和二甲双胍除了具有降血糖作用外，还有肾脏保护作用。本研究探讨了恩格列净和二甲双胍对糖尿病肾脏并发症的潜在保护作用。42 只成年雄性 Sprague Dawley 大鼠随机分为六组：正常对照组、糖尿病对照组、二甲双胍（250mg/kg）组、恩格列净（10mg/kg）组和联合治疗组。2 型糖尿病通过单次腹腔注射链脲佐菌素（40mg/kg），并在饮用水中添加 10%果糖溶液两周后诱导大鼠发生。八周后评估血糖、肌酐、尿素氮、炎症标志物（IL-6、TNF-α）和肾组织半胱氨酸天冬氨酸蛋白酶-3。与糖尿病组相比，治疗组的血糖、尿素、肌酐、血清 IL-6、TNF-α和组织半胱氨酸天冬氨酸蛋白酶-3显著降低。组织病理学检查结果显示，恩格列净和/或二甲双胍治疗改善了糖尿病肾病引起的肾组织损伤。此外，恩格列净和二甲双胍联合使用的效果更好。我们的数据表明，恩格列净和二甲双胍可改善糖尿病动物的肾功能，减少炎症和细胞凋亡，延缓糖尿病肾病的进展。二甲双胍和恩格列净联合治疗对肾组织具有附加的保护作用。
