Khunkit Pirawan, Wattana Konkanok
Department of Pharmaceutical Care Walailak University, Tha Sala, Nakhon Si Thammarat 80160, Thailand.
Drug and Cosmetics Excellence Center Walailak University, Tha Sala, Nakhon Si Thammarat 80161, Thailand.
Adv Pharmacol Pharm Sci. 2024 Aug 30;2024:7181515. doi: 10.1155/2024/7181515. eCollection 2024.
Sitagliptin functions similarly to GLP-1RAs by incretin and insulin secretion and has a renoprotective effect. Diabetic kidney disease (DKD) is a kidney complication that increases the mortality rate in type 2 diabetes mellitus (T2DM) patients. The important parameters that predict appropriate sitagliptin treatment are known as factors. This study aimed to assess factors that correlated with the renoprotective effect of sitagliptin in patients with T2DM.
This retrospective study collected data from a tertiary hospital in Thailand. All T2DM patients who were treated with sitagliptin and had complete data were recruited to analyze the outcome. The primary outcome was a correlation between demographics, laboratory data, and kidney outcome. The secondary outcome was the different laboratory results between pre- and posttreatment of patients treated with sitagliptin.
The number of patients who were treated for T2DM with sitagliptin was 191. Only 102 patients had complete laboratory parameters. Results showed a positive correlation between baseline FBS, Hb, and Scr change ( value = 0.042 and 0.005) at 6 months and baseline age, TG, and Scr change ( value = 0.010 and 0.022) at 18 months; while a negative correlation was observed between baseline FBS, Hb, and eGFR change ( value = 0.017 and 0.007) at 6 months and baseline age and eGFR change ( value = 0.010) and between HDL-cholesterol and Scr change at 18 months ( value = 0.044). The eGFR stage 1 subgroup showed a positive correlation between baseline Hb and Scr change ( value <0.001) and baseline DM duration and eGFR change ( value = 0.004). Moreover, sitagliptin showed statistically significant FBS, Hb, LDL-cholesterol, and TC reduction. Furthermore, HDL-cholesterol showed statistically significant elevation.
FBS, HbA1c, and age were factors that correlated with the renoprotective effect of sitagliptin. The eGFR ≥90.00 ml/min/1.73 m patients group showed a duration of DM in which factors correlated with renoprotective effect. Moreover, sitagliptin also can improve glucose levels and lipid profile.
西他列汀通过肠促胰岛素和胰岛素分泌发挥与胰高血糖素样肽-1受体激动剂（GLP-1RAs）相似的作用，并且具有肾脏保护作用。糖尿病肾病（DKD）是一种肾脏并发症，会增加2型糖尿病（T2DM）患者的死亡率。预测西他列汀合理治疗的重要参数即为相关因素。本研究旨在评估与西他列汀对T2DM患者肾脏保护作用相关的因素。
这项回顾性研究收集了泰国一家三级医院的数据。纳入所有接受西他列汀治疗且数据完整的T2DM患者以分析结果。主要结局是人口统计学、实验室数据与肾脏结局之间的相关性。次要结局是接受西他列汀治疗患者治疗前后不同的实验室检查结果。
接受西他列汀治疗的T2DM患者有191例。只有102例患者具有完整的实验室参数。结果显示，6个月时基线空腹血糖（FBS）、血红蛋白（Hb）与血清肌酐（Scr）变化之间呈正相关（P值分别为0.042和0.005），18个月时基线年龄、甘油三酯（TG）与Scr变化之间呈正相关（P值分别为0.010和0.022）；而6个月时基线FBS、Hb与估算肾小球滤过率（eGFR）变化之间呈负相关（P值分别为0.017和0.007），基线年龄与eGFR变化之间呈负相关（P值为0.010），18个月时高密度脂蛋白胆固醇（HDL-胆固醇）与Scr变化之间呈负相关（P值为0.044）。eGFR 1期亚组中，基线Hb与Scr变化之间呈正相关（P值<0.001），基线糖尿病病程与eGFR变化之间呈正相关（P值为0.004）。此外，西他列汀使FBS、Hb、低密度脂蛋白胆固醇（LDL-胆固醇）和总胆固醇（TC）有统计学意义的降低。此外，HDL-胆固醇有统计学意义的升高。
FBS、糖化血红蛋白（HbA1c）和年龄是与西他列汀肾脏保护作用相关的因素。eGFR≥90.00 ml/min/1.73m²患者组中显示出糖尿病病程与肾脏保护作用相关因素。此外，西他列汀还可改善血糖水平和血脂谱。
