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肾脏预后相关因素的基线值对托格列净治疗开始后其变化的影响:一项针对日本2型糖尿病合并肾损伤患者的回顾性研究

Effect of Baseline Values of Renal Prognosis-related Factors on Their Changes after Initiating Tofogliflozin Treatment: A Retrospective Study in Japanese Patients with Type 2 Diabetes and Renal Impairment.

作者信息

Matsumoto Suzuko, Ito Hiroyuki, Inoue Hideyuki, I Chiaki, Miura Shun, Antoku Shinichi, Yamasaki Tomoko, Mori Toshiko, Togane Michiko

机构信息

Department of Diabetes, Metabolism and Kidney Disease, Edogawa Hospital, Tokyo, Japan.

出版信息

JMA J. 2024 Oct 15;7(4):571-579. doi: 10.31662/jmaj.2024-0128. Epub 2024 Sep 6.

Abstract

INTRODUCTION

This study investigated the relationships between changes in renal prognosis-related factors after initiating tofogliflozin and the corresponding baseline values in clinical practice in Japanese patients with type 2 diabetes.

METHODS

We investigated the relationships between changes in hematocrit, hemoglobin, systolic blood pressure (sBP), urinary protein excretion (uPE), serum uric acid (sUA), and estimated glomerular filtration rate (eGFR) 12 months after initiating tofogliflozin (20 mg) and their corresponding baseline values in 130 patients with type 2 diabetes. The subjects were divided into two groups: normal (≥60 mL/min/1.73 m, n = 87) and low (<60 mL/min/1.73 m, n = 43) eGFR.

RESULTS

Although the change in eGFR was negatively correlated with the baseline value in the normal-eGFR group, no significant correlation was found between the change in eGFR and baseline value in the low-eGFR group. Although changes in hematocrit (r = -0.39, P = 0.01) and hemoglobin (r = -0.36, P = 0.02) levels were significantly negatively correlated with corresponding baseline values in the low-eGFR group, no significant correlations were observed in the normal-eGFR group. Changes in sBP, uPE, and sUA were significantly negatively correlated with the corresponding baseline values in both the normal- and low-eGFR groups. None of the correlation coefficients between the normal- and low-eGFR groups showed a significant difference.

CONCLUSIONS

Favorable changes in renal prognosis-related factors after tofogliflozin therapy may contribute to renoprotection in patients with type 2 diabetes and poor corresponding baseline values, despite the presence of renal impairment.

摘要

引言

本研究调查了日本2型糖尿病患者开始使用托格列净后肾脏预后相关因素的变化与相应基线值之间的关系。

方法

我们调查了130例2型糖尿病患者开始使用托格列净(20mg)12个月后血细胞比容、血红蛋白、收缩压(sBP)、尿蛋白排泄(uPE)、血清尿酸(sUA)和估计肾小球滤过率(eGFR)的变化与其相应基线值之间的关系。受试者分为两组:eGFR正常(≥60 mL/min/1.73 m²,n = 87)和eGFR低(<60 mL/min/1.73 m²,n = 43)。

结果

虽然正常eGFR组中eGFR的变化与基线值呈负相关,但低eGFR组中eGFR的变化与基线值之间未发现显著相关性。虽然低eGFR组中血细胞比容(r = -0.39,P = 0.01)和血红蛋白(r = -0.36,P = 0.02)水平的变化与相应基线值显著负相关,但正常eGFR组中未观察到显著相关性。正常和低eGFR组中sBP、uPE和sUA的变化与相应基线值均显著负相关。正常和低eGFR组之间的相关系数均无显著差异。

结论

托格列净治疗后肾脏预后相关因素的有利变化可能有助于对2型糖尿病且相应基线值较差的患者进行肾脏保护,尽管存在肾功能损害。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9b3/11543293/980aea528ca5/2433-3298-7-4-0571-g001.jpg

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