精准医学杂志 (Jun 2023)
EFFECTS OF LONG-TERM DAPAGLIFLOZIN ADMINISTRATION ON SYMPATHETIC NERVOUS ACTIVITY IN PATIENTS WITH DIABETES AND UNDERLYING MECHANISM
Abstract
Objective To investigate the effect of long-term dapagliflozin administration on sympathetic nervous activity in patients with diabetes and the underlying mechanism. Methods We included 100 patients with type 2 diabetes admitted to Heze Mudan People’s Hospital from June 2021 to July 2022. They were divided into diabetes group (50 cases) and dapagliflozin group (50 cases). The diabetes group received conventional treatment (metformin or acarbose), while the dapagliflozin group received conventional treatment plus dapagliflozin (10 mg, once daily). Both groups were treated for three months. We collected cli-nical data on body mass, body mass index, glucose metabolism, pancreatic islet function, renal function, cardiac function, and se-rum sympathetic nervous activity before and after treatment. The relationship between sympathetic activity and the protective effects of dapagliflozin on cardiac, renal and islet functions was analyzed. Results The two groups significantly differed in the differences in body mass, glucose metabolism, pancreatic islet function, and cardiac function (t=-5.57-4.65,P<0.05) and renal function, sympathetic activity indicators (Z=-7.02--4.38,P<0.05) before and after treatment. The correlation analysis showed that serum tyrosine hydroxylase was positively correlated with pancreatic islet function, renal function, and cardiac function indicators in the dapagliflozin group (r=0.29-0.31,P<0.05). The multiple linear regression analysis revealed that islet function was correlated with glucose metabolism in both groups (β=-2.15--1.40,t=-2.95--2.23,P<0.05); renal function and cardiac function were correlated with glucose metabolism in the diabetes group (β=0.92, 0.65,t=2.42, 2.51,P<0.05); islet function, renal function, and cardiac function were correlated with sympathetic activity in the dapagliflozin group (β=-0.01-0.01,t=-2.29-2.92,P<0.05). In the dapagliflozin group, the difference in serum norepinephrine level before and after treatment was significantly different between the patients aged 30-39 years and those aged 60-69 years (P<0.05). Conclusion Long-term dapagliflozin administration can inhibit increased sympathetic nervous activity in patients with type 2 diabetes, which is related to its protective effects on cardiac, renal, and pancreatic islet functions.
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