Pang Shaowei, Li Xiaoli
Nephrology Department, Baoji High Tech Hospital Baoji 721000, Shaanxi, China.
Am J Transl Res. 2024 Sep 15;16(9):4967-4978. doi: 10.62347/ARYA8831. eCollection 2024.
To evaluate the potential of sodium-glucose cotransporter 2 (SGLT2) inhibitors in preventing the progression of diabetic kidney disease and to provide guidance for clinical practice to improve renal health management strategies for diabetic patients.
A retrospective analysis was conducted on 178 patients with diabetic kidney disease admitted to Baoji High Tech Hospital from March 2023 to March 2024. Of these, 88 patients who received early treatment with the SGLT2 inhibitor dapagliflozin were included in the early SGLT2-i group, while 90 patients receiving later treatment with SGLT2 inhibitor dapagliflozin were included in the late SGLT2-i group. Clinical data, overall effectiveness, adverse reactions, blood glucose, renal function, lipid levels, and inflammatory markers were compared between the two groups.
Prior to treatment, there were no differences in blood glucose indicators between the two groups (all P > 0.05). Following treatment, both groups showed reductions in 2-hour postprandial blood glucose (2hPG), fasting plasma glucose (FPG), and glycosylated hemoglobin (HbA1c), with the early SGLT2-i group demonstrating significantly lower values compared to the late SGLT2-i group (all P < 0.05). Similarly, there were no differences in renal function indicators between the two groups before treatment (all P > 0.05). However, following treatment, the early SGLT2-i group showed more noticeable improvements compared to the late SGLT2-i group (P < 0.05). Inflammatory markers and lipid levels followed similar patterns. The overall effectiveness of the early SGLT2-i group was higher than that of the late SGLT2-i group (92.05% vs. 78.89%, P < 0.05), while the incidence of adverse reactions did not differ statistically between the two groups (6.82% vs. 10.00%, P > 0.05).
Early use of SGLT2 inhibitors in diabetic kidney disease patients effectively controls blood glucose and lipid levels, improves renal function, reduces inflammatory responses, and exhibits a low incidence of adverse reactions. This demonstrates high safety and an important role in delaying disease progression. Therefore, it is worth considering clinical promotion and use for this patient population.
评估钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂在预防糖尿病肾病进展中的潜力，并为临床实践提供指导，以改善糖尿病患者的肾脏健康管理策略。
对2023年3月至2024年3月入住宝鸡高新医院的178例糖尿病肾病患者进行回顾性分析。其中，88例早期接受SGLT2抑制剂达格列净治疗的患者纳入早期SGLT2-i组，90例后期接受SGLT2抑制剂达格列净治疗的患者纳入晚期SGLT2-i组。比较两组患者的临床资料、总体疗效、不良反应、血糖、肾功能、血脂水平及炎症指标。
治疗前，两组血糖指标无差异（均P>0.05）。治疗后，两组餐后2小时血糖（2hPG）、空腹血糖（FPG）和糖化血红蛋白（HbA1c）均降低，早期SGLT2-i组的值显著低于晚期SGLT2-i组（均P<0.05）。同样，治疗前两组肾功能指标无差异（均P>0.05）。然而，治疗后，早期SGLT2-i组较晚期SGLT2-i组改善更明显（P<0.05）。炎症指标和血脂水平呈现相似模式。早期SGLT2-i组的总体疗效高于晚期SGLT2-i组（92.05%对78.89%，P<0.05），而两组不良反应发生率无统计学差异（6.82%对10.00%，P>0.05）。
糖尿病肾病患者早期使用SGLT2抑制剂可有效控制血糖和血脂水平，改善肾功能，减轻炎症反应，且不良反应发生率低。这表明其安全性高，在延缓疾病进展中起重要作用。因此，值得考虑在该患者群体中进行临床推广应用。
