Unlusoy Yagmur Busra, Dizdar Oguzhan Sıtkı, Gunal Ali İhsan
Department of Internal Medicine, Kayseri City Training and Research Hospital, Kayseri, Turkey.
Department of Internal Medicine and Clinical Nutrition, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
Arch Endocrinol Metab. 2025 Jul 24;69(3):e240485. doi: 10.20945/2359-4292-2024-0485.
To ascertain the impact of combining sodium-glucose cotransporter 2 inhibitors (SGLT2is) with thiazolidinediones on fluid balance in patients with type 2 diabetes mellitus.
This prospective study followed patients over a 6-month period, with data collected at three time points. The study commenced with the administration of pioglitazone on the same day. At the 3-month mark of the study, SGLT2is (dapagliflozin or empagliflozin) were subsequently integrated into the patients' treatment regimens. At each time point, bioimpedance spectroscopy was employed to the volume status of the patients, and an assessment of their glycemic, renal, and lipid parameters was conducted. Their fluid status was evaluated on the basis of the overhydration value and the relative hydration index.
The study sample consisted of 60 type 2 diabetes mellitus patients with a mean age of 52.5 years. While notable increases in the mean overhydration value and relative hydration index were observed during the initial 3-month period (p < 0.001), a significant decline was evident in the second 3-month period (p < 0.001). However, no significant change in the adipose tissue index, fat mass, or body cell mass was found at the 6-month follow-up. Significant improvements were achieved in liver function test results, glycemic parameters, and the lipid profile. Renal parameters did not change significantly during the 6-months of follow-up.
SGLT2is have been shown to be effective in improving fluid retention associated with thiazolidinediones and in maintaining euvolemic fluid status.
确定将钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）与噻唑烷二酮类药物联合使用对2型糖尿病患者体液平衡的影响。
这项前瞻性研究对患者进行了为期6个月的随访，在三个时间点收集数据。研究于同一天开始给予吡格列酮。在研究的3个月时，随后将SGLT2i（达格列净或恩格列净）纳入患者的治疗方案。在每个时间点，采用生物电阻抗光谱法评估患者的容量状态，并对其血糖、肾脏和血脂参数进行评估。根据水合过量值和相对水合指数评估他们的体液状态。
研究样本包括60例2型糖尿病患者，平均年龄52.5岁。在最初的3个月期间，平均水合过量值和相对水合指数显著增加（p<0.001），而在第二个3个月期间则明显下降（p<0.001）。然而，在6个月的随访中，脂肪组织指数、脂肪量或体细胞量没有显著变化。肝功能测试结果、血糖参数和血脂谱有显著改善。在6个月的随访期间，肾脏参数没有显著变化。
已证明SGLT2i在改善与噻唑烷二酮类药物相关的液体潴留和维持正常血容量体液状态方面有效。
