SGLT2抑制剂改善2型糖尿病患者血浆动脉粥样硬化生物标志物:一项真实世界的回顾性观察研究。

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Minerva endocrinology Pub Date : 2023-09-01 Epub Date: 2021-05-12 DOI:10.23736/S2724-6507.21.03465-5
Eren Imre, Hatice G Gunhan, Pinar Erel, Ozlem Ustay
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引用次数: 6

摘要

背景:有一些具有成本效益、非侵入性和预测性的工具可用于预测糖尿病患者的心血管疾病风险,如“血浆动脉粥样硬化指数(AIP)”,其定义为空腹血浆TG(mg/dL)与HDL-C之比的对数[log(TG/HDL-C)],甘油三酯与高密度脂蛋白(TG-to-HDL-C)的比率和甘油三酯-葡萄糖(TyG)指数,其计算为Ln(空腹TG[mg/dL]×空腹血糖(mg/dL)/2)。这些工具是动脉粥样硬化的间接标志物。达格列嗪和恩帕列嗪具有心血管有益作用,本研究评估了钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)对2型糖尿病患者AIP、TyG指数和TG-HDL-C比值的影响。方法:这项单中心、回顾性、观察性研究涉及2017年1月至2019年6月在内分泌门诊接受SGLT2i治疗的2型糖尿病患者。从患者档案中收集人口统计学和临床数据。在第一次就诊和第六个月就诊时计算AIP、TyG指数和TG-HDL-C比率。结果:本研究共招募了143名T2DM患者(75名女性,68名男性)。66名患者服用达格列嗪(46.2%),77名患者服用恩帕列嗪(53.8%)。SGLT2i治疗除了血清甘油三酯(TG)水平外,没有改变脂质状况。SGLT2i治疗6个月后,血清TG水平显著降低(P=0.045)。在6个月的随访中,所有患者的AIP都显著降低(P结论:达格列嗪和恩帕列嗪都显著影响AIP和TyG指数,这表明无论是否使用他汀类药物治疗,无论脂质参数如何,都有动脉粥样硬化心血管风险。
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SGLT2 inhibitors improve plasma atherogenic biomarkers in patients with type 2 diabetes: a real-world retrospective observational study.

Background: There are cost-effective, non-invasive, and predictive tools used to predict the CVD risk in patients with diabetes such as the "atherogenic index of plasma (AIP)" which is defined as the logarithm to the base 10 of the ratio of fasting plasma TG (mg/dL) to HDL-C [log (TG/HDL-C)], triglyceride to high density lipoprotein (TG-to-HDL-C) ratio and the triglyceride glucose (TyG) index which is calculated as Ln (fasting TG [mg/dL] × fasting blood glucose (mg/dL)/2). These tools are indirect markers of atherosclerosis. Dapagliflozin and empagliflozin have exhibited cardiovascular beneficial effects and this study evaluated the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on AIP, TyG index and TG-to-HDL-C ratio in patients with type 2 diabetes.

Methods: This single center, retrospective, observational study involved patients with type 2 diabetic patients who were prescribed SGLT2i in the endocrinology outpatient clinic between January 2017 and June 2019. Demographic and clinical data were collected from patient files. AIP, TyG index and TG-to-HDL-C ratio were calculated obtained at the first visit and the sixth month visit.

Results: Overall, 143 patients with T2DM (75 women, 68 men) were recruited in this study. Sixty-six patients were prescribed dapagliflozin (46.2%), and 77 were prescribed empagliflozin (53.8%). SGLT2i treatment did not alter the lipid profile except the serum triglyceride (TG) levels. Serum TG levels were significantly reduced after 6 months of SGLT2i therapy (P=0.045). All patients had significant reductions in AIP at 6-month follow-up (P<0.001), accompanied by a significant reduction in TyG index (P<0.001). Both empagliflozin and dapagliflozin caused significant decrease in AIP (P=0.043 and P<0.001, respectively) and TyG index (P=0.010 and P<0.001, respectively).

Conclusions: Both dapagliflozin and empagliflozin were noted to significantly affect AIP and TyG indexes, which indicate atherosclerotic cardiovascular risk, with or without statin treatment regardless of lipid parameters.

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