达格列净对2型糖尿病患者糖代谢、脂代谢状态及肾损伤标志物水平的影响

Effects of dapagliflozin on glucolipid metabolism and levels of renal injury markers in patients with type 2 diabetes mellitus

  • 摘要:
      目的  分析应用达格列净对2型糖尿病(T2DM)患者糖代谢、脂代谢状态及尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)等肾损伤标志物水平的影响。
      方法  回顾性分析应用达格列净治疗及未应用达格列净治疗的T2DM患者的临床资料,分别纳入观察组及对照组,每组54例。记录2组治疗前后糖代谢、脂代谢、血压、体质量、肾功能及肾损伤指标及治疗期间的不良反应。
      结果  治疗24周后,2组外周血空腹血糖(FBG)、糖化血红蛋白(HbAlc)水平及体质量、体质量指数(BMI)均较治疗前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。治疗后,2组脂代谢指标均较治疗前好转,但2组间比较,差异无统计学意义(P>0.05)。治疗24周后,观察组收缩压(SBP)及尿α1-微球蛋白(α1-MG)、β2-MG、尿NAG水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P < 0.05)。2组治疗期间不良反应总发生率比较,差异无统计学意义(P>0.05)。
      结论  达格列净对T2DM患者的降糖、降压效果较好,不良反应少,且能降低部分肾损伤标志物,可能具有肾脏保护作用。

     

    Abstract:
      Objective  To analyze the influence of dapagliflozin on glucolipid metabolism status and levels of renal injury markers such as urine β2 microglobulin (β2-MG) and N-acetyl-β-D-glucosaminidase (NAG) in patients with type 2 diabetes mellitus (T2DM).
      Methods  The data of 54 patients with T2DM who were treated with dapagliflozin (observation group) and not treated with dapagliflozin (control group) in our hospital was retrospectively analyzed. The glucolipid metabolism, blood pressure, body weight, renal function and renal injury indicators before and after treatment and adverse reactions during treatment were recorded in the two groups.
      Results  After 24 weeks of treatment, the levels of peripheral blood fasting blood glucose (FBG), glycated hemoglobin (HbALc), body weight and body mass index (BMI) in the two groups were decreased compared with those before treatment, and the above indexes of observation group were significantly lower than those of control group (P < 0.05). The lipid metabolism indexes in the two groups were improved compared with those before treatment, but there was no statistically significant differences between two groups (P>0.05). After 24 weeks of treatment, the systolic blood pressure (SBP) and levels of urine α1-microglobulin (α1-MG), urine β2-MG and urine NAG in the observation group were significantly decreased compared with those before treatment, and were significantly lower than those in the control group (P < 0.05). There was no statistically significant difference in the total incidence rate of adverse reactions between the two groups during treatment (P>0.05).
      Conclusion  Dapagliflozin has better effects in lowering blood glucose and blood pressure in patients with T2DM, and fewer adverse reactions. It can reduce the partial renal injury markers and may have a renal protective effect.

     

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