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首页> 外文期刊>Journal of Clinical Medicine Research >Impact of Dapagliflozin Therapy on Renal Protection and Kidney Morphology in Patients With Uncontrolled Type 2 Diabetes Mellitus
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Impact of Dapagliflozin Therapy on Renal Protection and Kidney Morphology in Patients With Uncontrolled Type 2 Diabetes Mellitus

机译：达格列净治疗对2型糖尿病失控患者肾脏保护和肾脏形态的影响

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Background: We examined whether the sodium-glucose cotransporter-2 inhibitor (SGLT2i) dapagliflozin can improve urine albumin-to-creatinine ratio (UACR) associated with a reduction in body weight or body fat in patients with type 2 diabetes mellitus (T2DM).Methods: We prospectively recruited T2DM patients having inadequate glycemic control (hemoglobin A1c (HbA1c) > 7.0%) not on SGLT2i therapy. We treated the patients with add-on dapagliflozin treatment or intensification of non-SGLT2 inhibitor therapies for 6 months. We measured UACR, urine N-acetyl-β-glucosaminidase (uNAG), and body composition including total body fat mass (TBFM) as assessed by bioelectrical impedance analysis. We also investigated changes in length and radiation attenuation properties of the kidneys and abdominal fat area using computed tomography.Results: We enrolled 62 patients with a mean HbA1c of 8.0%. The HbA1c and fasting blood glucose were significantly decreased in both the dapagliflozin-group and non-SGLT2i-group, with no significant difference between the two groups. Dapagliflozin treatment, but not non-SGLT2i treatment, significantly decreased UACR and uNAG. The changes in UACR and uNAG were significantly greater in the dapagliflozin group compared with the non-SGLT2i group. Dapagliflozin treatment, but not non-SGLT2i treatment, significantly decreased the body weight, TBFM, and abdominal fat area and significantly increased kidney length and radiation attenuation. The percentage change in UACR was significantly correlated with changes in TBFM, but not with body weight. By multivariate logistic regression analysis, dapagliflozin treatment was significantly associated with the improvement of UACR.Conclusions: Add-on treatment with dapagliflozin exhibited significant renoprotective effects, with improvement of UACR and uNAG and increased kidney length and radiation attenuation in patients with uncontrolled T2DM.J Clin Med Res. 2018;10(6):466-477doi: https://doi.org/10.14740/jocmr3419w.
机译：背景：我们检查了2型糖尿病（T2DM）患者中的钠葡萄糖共转运蛋白2抑制剂（SGLT2i）dapagliflozin是否可以改善尿白蛋白与肌酐的比率（UACR），从而减轻体重或降低体内脂肪。方法：我们前瞻性招募了未接受SGLT2i治疗的血糖控制不足（血红蛋白A1c（HbA1c）> 7.0％）的T2DM患者。我们对患者进行了附加的达格列净治疗或强化非SGLT2抑制剂治疗，为期6个月。我们通过生物电阻抗分析评估了UACR，尿液N-乙酰基-β-氨基葡萄糖苷酶（uNAG）以及包括总身体脂肪量（TBFM）在内的身体成分。我们还使用计算机体层摄影术研究了肾脏和腹部脂肪区域的长度和辐射衰减特性的变化。结果：我们招募了62例HbA1c平均为8.0％的患者。达格列净组和非SGLT2i组的HbA1c和空腹血糖均显着降低，两组之间无显着差异。达格列净治疗（而非非SGLT2i治疗）显着降低了UACR和uNAG。与非SGLT2i组相比，达格列净治疗组的UACR和uNAG的变化明显更大。达格列净治疗（而非非SGLT2i治疗）可显着降低体重，TBFM和腹部脂肪区域，并显着增加肾脏长度和放射衰减。 UACR的百分比变化与TBFM的变化显着相关，但与体重无关。通过多因素logistic回归分析，达格列净治疗与UACR改善显着相关。临床医学研究。 2018; 10（6）：466-477doi：https://doi.org/10.14740/jocmr3419w。

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