精准医学杂志 (Feb 2023)
EFFECT OF THE SGLT2 INHIBITOR DAPAGLIFLOZIN ON RENAL FUNCTION AND RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM IN ELDERLY PATIENTS WITH EARLY DIABETIC KIDNEY DISEASE
Abstract
Objective To investigate the effect of the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin on renal function and renin-angiotensin-aldosterone system (RAAS) in elderly patients with early diabetic kidney disease (DKD). Methods A total of 97 elderly patients with type 2 diabetes mellitus (T2DM) who attended our hospital from September 1, 2019 to August 1, 2021 were enrolled, and according to urinary albumin-to-creatinine ratio (UACR), they were divided into normal UACR group and early DKD group. A random number table was further used to determine whether each patient in the above two groups was treated with dapagliflozin. Finally, all patients were divided into normal-UACR dapagliflozin group (group A), normal-UACR control group (group B), early-DKD dapagliflozin group (group C), and early-DKD control group (group D), and these four groups were compared in terms of the changes in related clinical indices at 1 year after treatment. Results After 1 year of treatment, group A had significant changes in body mass index (BMI), systolic blood pressure, diastolic blood pressure, UACR, annualized relapse rate (ARR), fasting blood glucose, and fasting insulin (t=2.098-7.122,P<0.05), while group B had significant changes in UACR, estimated glomerular filtration rate (eGFR), fasting blood glucose, and fasting insulin (t=-4.094-4.833,P<0.05), and compared with group B, group A had significantly greater changes in systolic blood pressure, UACR, eGFR, fashing insulin, and renin level in the standing position after treatment (t=-3.364-7.203,P<0.05). After treatment, group C had significant changes in BMI, systolic blood pressure, UACR, fasting blood glucose, and fasting insulin (t=2.168-6.421,P<0.05), while group D had significant changes in UACR, eGFR, fasting blood glucose, and fasting insulin (t=-3.422-4.951,P<0.05), and compared with group D, group C had significantly greater changes in BMI, UACR, eGFR, and renin level in the standing position after treatment (t=-4.178-6.023,P<0.05). Compared with group C, group A had significantly greater changes in diastolic blood pressure, UACR, ARR, and fasting insulin after treatment (t=-5.297-3.217,P<0.05). Conclusion The SGLT2 inhibitor dapagliflozin can reduce systolic blood pressure and UACR and improve renal function in elderly patients with T2DM. But The SGLI2 inhibitor dapagliflozin has no effect on RAAS in T2DM patients with early DKD.
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