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超重和肥胖的囊性纤维化相关糖尿病患者的SGLT2抑制剂治疗:病例系列

SGLT2 inhibitor therapy in overweight and obese patients with cystic fibrosis-related diabetes: Case series.

作者信息

Ahmed Ammar, Asirvatham Roshini, Ullal Jagdeesh, Moheet Amir

机构信息

Division of Endocrinology,Diabetes and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, United States.

School of Medicine, University of Minnesota, Twin Cities, MN, United States.

出版信息

J Clin Transl Endocrinol. 2025 Jun 23;41:100403. doi: 10.1016/j.jcte.2025.100403. eCollection 2025 Sep.

DOI:10.1016/j.jcte.2025.100403
PMID:40672774
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12264597/
Abstract

Cystic fibrosis-related diabetes (CFRD) is the most prevalent extrapulmonary comorbidity in CF. While insulin remains the standard treatment, increasing rates of overweight and obesity due to CFTR modulators highlight the need for new therapies. SGLT2 inhibitors, effective in type 2 diabetes, have not been studied in CFRD. This case series presents eight CFRD patients treated with SGLT2 inhibitors alongside insulin for one year. Half had BMI reductions (1.33-2.89 kg/m2); others had increases. Glycemic control improved in six, worsened in two due to insulin nonadherence. Insulin adjustments showed no pattern. One patient discontinued due to genital infections; overall tolerance was high.

摘要

囊性纤维化相关糖尿病(CFRD)是囊性纤维化(CF)中最常见的肺外合并症。虽然胰岛素仍然是标准治疗方法,但由于CFTR调节剂导致超重和肥胖的发生率不断上升,凸显了对新疗法的需求。钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂对2型糖尿病有效,但尚未在CFRD中进行研究。本病例系列介绍了8例接受SGLT2抑制剂联合胰岛素治疗一年的CFRD患者。一半患者的体重指数(BMI)降低(1.33 - 2.89kg/m²);其他患者则升高。6例患者的血糖控制得到改善,2例因胰岛素治疗依从性差而恶化。胰岛素调整无规律可循。1例患者因生殖器感染停药;总体耐受性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5892/12264597/f5402f955abe/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5892/12264597/308089d36f77/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5892/12264597/f5402f955abe/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5892/12264597/308089d36f77/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5892/12264597/f5402f955abe/gr2.jpg

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本文引用的文献

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Glucagon-like peptide1 receptor agonist treatment of cystic fibrosis-related diabetes complicated by obesity: A cases series and literature review.胰高血糖素样肽-1受体激动剂治疗合并肥胖的囊性纤维化相关糖尿病:病例系列及文献综述
J Clin Transl Endocrinol. 2024 Nov 7;38:100375. doi: 10.1016/j.jcte.2024.100375. eCollection 2024 Dec.
2
ISPAD Clinical Practice Consensus Guidelines 2022: Management of cystic fibrosis-related diabetes in children and adolescents.《国际儿童青少年糖尿病协会2022年临床实践共识指南:儿童和青少年囊性纤维化相关糖尿病的管理》
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Efficacy and safety of sodium-glucose cotransporter 2 inhibitors initiation in patients with acute heart failure, with and without type 2 diabetes: a systematic review and meta-analysis.
钠-葡萄糖共转运蛋白 2 抑制剂在伴或不伴 2 型糖尿病的急性心力衰竭患者中的疗效和安全性:系统评价和荟萃分析。
Cardiovasc Diabetol. 2022 Feb 5;21(1):20. doi: 10.1186/s12933-022-01455-2.
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Dapagliflozin in Patients with Chronic Kidney Disease.达格列净治疗慢性肾脏病患者。
N Engl J Med. 2020 Oct 8;383(15):1436-1446. doi: 10.1056/NEJMoa2024816. Epub 2020 Sep 24.
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J Cyst Fibros. 2020 Jan;19(1):3-5. doi: 10.1016/j.jcf.2019.12.002. Epub 2019 Dec 13.
7
Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction.达格列净治疗射血分数降低的心力衰竭患者。
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Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes.达格列净与 2 型糖尿病患者的心血管结局
N Engl J Med. 2019 Jan 24;380(4):347-357. doi: 10.1056/NEJMoa1812389. Epub 2018 Nov 10.
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Sci Rep. 2017 Dec 8;7(1):17231. doi: 10.1038/s41598-017-17404-z.
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