Department of Pharmacy, International University of Health and Welfare Hospital, Tochigi, Japan.
Graduate School of Pharmaceutical Sciences, International University of Health and Welfare, Tochigi, Japan.
In Vivo. 2024 Nov-Dec;38(6):2767-2773. doi: 10.21873/invivo.13756.
BACKGROUND/AIM: In several studies, Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have been reported to increase hemoglobin (Hb) levels. In a study in which Hb levels were compared between patients who received SGLT2i and dipeptidyl peptidase-4 inhibitors, some patients exhibited increased Hb levels (>1.0 g/dl), whereas some exhibited unchanged Hb levels. Notably, several factors may influence the Hb-increasing effect of SGLT2i. This study aimed to analyze the factors influencing the Hb-increasing effect of SGLT2i.
Type 2 diabetes patients were divided into three groups: SGLT2i (SGLT2i only group, n=36), those receiving a combination of SGLT2i and angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs) (SGLT2i+ACEi/ARBs group, n=32), and those not receiving these drugs (control group, n=49). We retrospectively analyzed Hb changes in these groups. Kaplan-Meier curves compared Hb changes from SGLT2i initiation to day 63, with an Hb increase defined as ≥0.5 g/dl. In addition, sex, age, ACEi/ARBs, estimated glomerular filtration rate, and hematocrit levels were analyzed using Cox proportional hazards as factors influencing Hb-increasing events.
Hb-increasing event rates were 61%, 41%, and 20% in the SGLT2i only, SGLT2i+ACEi/ARBs, and control groups, respectively. The Kaplan-Meier curves showed significantly higher Hb-increasing event rates in the SGLT2i only group than in the control and SGLT2i+ACEi/ARBs groups. In the Cox proportional hazards model, ACEi/ARBs use was associated with a 39% reduction in the incidence of Hb-increasing events.
SGLT2i exhibit a Hb-increasing effect, which may be reduced by ACEi/ARBs.
背景/目的：在几项研究中，钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）已被报道可升高血红蛋白（Hb）水平。在一项比较接受 SGLT2i 和二肽基肽酶-4 抑制剂的患者之间 Hb 水平的研究中，一些患者 Hb 水平升高（>1.0 g/dl），而一些患者 Hb 水平不变。值得注意的是，有几个因素可能会影响 SGLT2i 的 Hb 升高作用。本研究旨在分析影响 SGLT2i 的 Hb 升高作用的因素。
2 型糖尿病患者分为三组：SGLT2i（仅 SGLT2i 组，n=36）、同时接受 SGLT2i 和血管紧张素转换酶抑制剂（ACEi）或血管紧张素受体阻滞剂（ARB）治疗的患者（SGLT2i+ACEi/ARB 组，n=32）和未接受这些药物治疗的患者（对照组，n=49）。我们回顾性分析了这些组的 Hb 变化。Kaplan-Meier 曲线比较了从 SGLT2i 开始到第 63 天的 Hb 变化，Hb 增加定义为≥0.5 g/dl。此外，使用 Cox 比例风险分析性别、年龄、ACEi/ARB、估算肾小球滤过率和红细胞压积水平作为影响 Hb 升高事件的因素。
仅 SGLT2i、SGLT2i+ACEi/ARB 和对照组的 Hb 升高事件发生率分别为 61%、41%和 20%。Kaplan-Meier 曲线显示，仅 SGLT2i 组的 Hb 升高事件发生率明显高于对照组和 SGLT2i+ACEi/ARB 组。在 Cox 比例风险模型中，ACEi/ARB 的使用与 Hb 升高事件发生率降低 39%相关。
SGLT2i 具有升高 Hb 的作用，而 ACEi/ARB 可能会降低这种作用。
