钠葡萄糖共转运蛋白2抑制剂对糖尿病肾脏病合并代谢综合征患者肾功能的影响
The effect of SGLT-2i on renal function in patients with diabetic kidney disease combined with metabolic syndrome
王蒲银 1杨爽 2徐丹萍 2丁涵露1
作者信息
- 1. 西南医科大学临床医学院,四川 泸州 646000;四川省医学科学院· 四川省人民医院肾内科,四川 成都 610072
- 2. 四川省医学科学院· 四川省人民医院肾内科,四川 成都 610072
- 折叠
摘要
目的 分析钠葡萄糖共转运蛋白2 抑制剂(SGLT-2i)对糖尿病肾脏病(DKD)合并代谢综合征(MS)患者的肾小球滤过率(eGFR)斜率与预后的影响.方法 DKD合并MS患者130 例,根据治疗方法分为常规治疗联合SGLT-2i组(联合组)和常规治疗组(常规组)各65 例,比较两组患者的eGFR斜率及预后.结果 治疗6 个月以上,联合组高密度脂蛋白胆固醇(HDL-C)高于常规组,血尿酸、总胆固醇(TC)、甘油三酯(TG)、空腹血糖低于常规组(P<0.05);联合组eGFR斜率低于常规组,两组eGFR斜率差异有统计学意义(P<0.05).生存分析提示联合组延缓eGFR下降(P<0.05);多因素COX回归分析显示eGFR斜率、血尿酸是发生肾脏终点事件的独立危险因素(P<0.05).结论 SGLT-2i可降低DKD合并MS患者eGFR斜率,改善肾脏预后;eGFR斜率、血尿酸是DKD合并MS患者进展到肾脏终点事件的独立危险因素.
Abstract
Objective To analyze the effect of sodium-glucose cotransporter protein 2 inhibitor(SGLT-2i)on glomerular filtration rate(eGFR)slope and prognosis in patients with diabetic kidney disease(DKD)combined with metabolic syndrome(MS).Methods One hundred and thirty patients with DKD combined with MS were divided into a conventional treatment combined with SGLT-2i group and a conventional treatment group according to the treatment methods.The eGFR slopes and prognosis were compared between the two groups.Results After more than 6 months of treatment,the high-density lipoprotein cholesterol(HDL-C)was higher and the blood uric acid,total cholesterol(TC),triglyceride(TG),and fasting glucose were lower in the combined group than those in the conventional group(P<0.05).The eGFR slope of the combined group was lower than that of the conventional group,and the difference of the eGFR slopes between the two groups was statistically significant(P<0.05).Survival analysis suggested that the com-bination group delayed the decline of eGFR(P<0.05).Multifactorial COX regression analysis showed that eGFR slope and blood uric acid were independent risk factors for the occurrence of renal endpoint events(P<0.05).Conclusions SGLT-2i can reduce the eGFR slope and improve the renal prognosis in patients with DKD combined with MS.eGFR slope and blood uric acid are independent risk factors for progression to renal endpoint events in patients with DKD combined with MS.
关键词
SGLT-2抑制剂/糖尿病肾脏病/代谢综合征/肾小球滤过率斜率/预后Key words
SGLT-2 inhibitor/Diabetic kidney disease/Metabolic syndrome/Glomerular filtration rate slope/Prognosis引用本文复制引用
基金项目
四川省科技厅应用基础项目(2018JY0332)
出版年
2024
NETL
NSTL
万方数据