卡格列净对2型糖尿病肾病患者体脂量、糖脂代谢以及肾损伤指标的影响  

Effects of canagliflozin on body fat mass, glucose and lipid metabolism and kidney damage indexes in patients with type 2 diabetic nephropathy

作　　者：曹冰[1,2] 张艳[2] 任荣[2] 陆晨[1] Cao Bing;Zhang Yan;Ren Rong;Lu Chen(Department of Nephrology,the First Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China;Department of Nephrology,the Fifth Affiliated Hospital of Xinjiang Medical University,Wulumuqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院肾内科,乌鲁木齐830000 [2]新疆医科大学第五附属医院肾内科,乌鲁木齐830000

出　　处：《国际泌尿系统杂志》2023年第3期390-394,共5页International Journal of Urology and Nephrology

基　　金：新疆维吾尔自治区自然科学基金 (2020D01C219)。

摘　　要：目的探讨卡格列净对2型糖尿病肾病患者体脂量、糖脂代谢以及肾损伤指标的影响。方法回顾性选取2020年3月至2021年6月于新疆医科大学第五附属医院肾病科住院期间明确诊断为2型糖尿病肾病的100例患者,将其分为观察组(行卡格列净+常规降糖治疗)和对照组(行常规降糖治疗),每组各50例。记录两组治疗前后的血压、身高、体重、体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平,检测尿微量白蛋白(mALB)、尿a1微球蛋白(a1-MG)、尿β2微球蛋白(β2-MG)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、尿白蛋白/肌酐比值(ACR)、24 h尿蛋白定量,并观察药物不良反应。结果两组治疗前的所有指标比较,差异均无统计学意义(均P>0.05),观察组治疗后的体重、BMI较治疗前降低,差异均有统计学意义(均P<0.05),治疗后,观察组的体重、BMI低于对照组,差异均有统计学意义(均P<0.05);两组治疗后的FPG、HbA1c较治疗前降低,差异均有统计学意义(均P<0.05),治疗后,观察组的FPG、HbA1c较对照组更低,但差异均无统计学意义(均P>0.05)。两组治疗前、后的TC、TG、LDL-C、HDL-C比较,差异均无统计学意义(均P>0.05)。观察组治疗后的血尿酸(UA)、mALB、ACR、24 h尿蛋白定量与治疗前比较,差异均有统计学意义(均P<0.05)。治疗后,对照组的ACR较治疗前降低,差异有统计学意义(P<0.05)。观察组治疗后的UA、mALB、ACR、24 h尿蛋白定量低于对照组,差异均有统计学意义(均P<0.05)。两组药物不良反应比较,差异无统计学意义(4.00%vs.2.00%,P>0.05)。结论卡格列净能有效降低血糖,降低糖尿病肾病患者的体脂量,同时还能减少尿蛋白的排泄,有较好的肾脏保护作用,安全性良好,值得临床进一步推广。Objective To investigate the effect of canagliflozin on body fat mass,glucose and lipid metabolism and kidney damage indexes in patients with type 2 diabetic nephropathy.Methods A total of 100 patients with type 2 diabetic nephropathy who were admitted to The Fifth Affiliated Hospital of Xinjiang Medical University from March 2020 to June 2021 were retrospectively selected and divided into observation group(receiving canagliflozin+routine hypoglycemic treatment)and control group(receiving routine hypoglycemic treatment),with 50 cases in each group.The blood pressure,height,weight,body mass index(BMI),fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)levels of the two groups before and after treatment were recorded.Urine microalbumin(mALB),urine a1 microglobulin(a1-MG),urineβ2 microglobulin(β2-MG),urine N-acetyl-β-D-glucosaminidase(NAG),urine albumin/creatinine ratio(ACR)and 24-hour urine protein were detected,and adverse drug reactions were observed.Results There were no statistically significant differences in all indicators between the two groups before treatment(all P>0.05).After treatment,the body weight and BMI of the observation group were lower than those before treatment,and the differences were statistically significant(all P<0.05).After treatment,the FPG and HbA1c of the two groups were lower than those before treatment,and the differences were statistically significant(all P<0.05).After treatment,the FPG and HbA1c of the observation group were lower than those of the control group,but the differences were not statistically significant(all P>0.05).There was no significant difference in TC,TG,LDL-C and HDL-C between the two groups before and after treatment(all P>0.05).There were statistically significant differences in UA,mALB,ACR and 24-hour urine protein in the observation group after treatment compared with those before treatment(all P<0.05).After treatment,the ACR o

关 键 词：糖尿病肾病 卡格列净 体脂量 糖脂代谢 肾损伤 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]