SGLT2抑制剂治疗2型糖尿病肾病效果及与SUA Smad1蛋白脂蛋白的相关性

doi:10.3969/j.issn.1006-6233.2023.05.014

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摘要 目的:观察SGLT2抑制剂治疗2型糖尿病肾病(Type 2 diabetic nephropathy,T2DN)效果,分析T2DN与血尿酸(Serum uric acid,SUA)、Smad1蛋白、脂蛋白的相关性。方法:回顾性分析本院2020年4月至2022年3月收治的72例T2DN患者的临床资料(研究组),根据患者尿白蛋白排泄率(Urinary albumin excretion rate,UAER),统计早期糖尿病肾病(UAER 30-300mg/24h)、临床糖尿病肾病(UAER>300mg/24h)者例数,连续接受3个月的SGLT2抑制剂治疗(10mg/次,1d/次)后,评估治疗效果及不良反应。另选取同期在本院进行健康体检的54例健康者作为对照组。对比不同人群SUA、Smad1蛋白、脂蛋白的水平,采用Spearman分析上述因子与UAER间的相关性。结果:研究组SUA、Smad1蛋白、脂蛋白水平均高于对照组(P<0.05)。72例T2DN患者经治疗后总有效率为87.50%(63/72),不良反应总发生率为9.72%(7/72)。治疗后,T2DN患者SUA、Smad1蛋白、脂蛋白水平较治疗前降低(P<0.05)。经统计,早期糖尿病肾病组45例,临床糖尿病肾病组27例。治疗前,早期糖尿病肾病组SUA、Smad1蛋白及脂蛋白水平均低于临床糖尿病肾病组(P<0.05)。治疗后,两组患者SUA、Smad1蛋白、脂蛋白水平较治疗前降低,其中早期糖尿病肾病组低于临床糖尿病肾病组(P<0.05)。Spearman分析结果显示:SUA、Smad1蛋白、脂蛋白表达与UAER均呈正相关关系(P<0.001)。结论:SUA、Smad1蛋白、脂蛋白在T2DN患者中呈高表达,经SGLT2抑制剂治疗可降低SUA、Smad1蛋白、脂蛋白的水平,不良反应低。临床通过检测SUA、Smad1蛋白、脂蛋白水平,可反映患者肾损伤程度,对制定治疗方案有一定指导价值。

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关键词 ： 2型糖尿病肾病, SGLT2抑制剂, 血尿酸, Smad1蛋白, 脂蛋白

Abstract：Objective: To observe the effectiveness of SGLT2 inhibitor on type 2 diabetic nephropathy (T2DN) and analyze the correlation between T2DN and serum uric acid (SUA), Smad1 protein and lipoprotein.Methods: The clinical data of 72 patients with T2DN admitted in our hospital from April 2020 to March 2022 (study group) were analyzed retrospectively. Based on the urinary albumin excretion rate (UAER), the number of patients with early stage diabetic nephropathy (UAER 30-300mg/24h) and clinical diabetic nephropathy (UAER >300mg/24h) were counted, and the treatment effect and adverse effects were evaluated after receiving SGLT2 inhibitor treatment (10mg/dose, 1d/dose) for 3 consecutive months.Another 54 healthy individuals who underwent health checkups at our hospital during the same period were selected as the control group. The levels of SUA, Smad1 protein and lipoprotein were compared in different populations, and the correlation between the above factors and UAER was analyzed by Spearman.Results: The SUA, Smad1 protein, and lipoprotein levels in the study group were higher than those in the control group (P<0.05). 72 patients with T2DN had an overall effectiveness of 87.50% (63/72) after treatment, and the overall incidence of adverse effects was 9.72% (7/72). After treatment, SUA, Smad1 protein, and lipoprotein levels were reduced in T2DN patients compared with those before treatment (P<0.05). Statistically, there were 45 cases in the early diabetic nephropathy group and 27 cases in the clinical diabetic nephropathy group. Before treatment, SUA, Smad1 protein and lipoprotein levels in the early diabetic nephropathy group were lower than those in the clinical diabetic nephropathy group (P<0.05). After treatment, the levels of SUA, Smad1 protein and lipoprotein decreased in both groups compared with those before treatment, with the early diabetic nephropathy group being lower than the clinical diabetic nephropathy group (P<0.05). Spearman analysis showed that the expression of SUA, Smad1 protein and lipoprotein were positively correlated with UAER (P<0.001).Conclusion: SUA, Smad1 protein and lipoprotein were highly expressed in T2DN patients. SGLT2 inhibitor treatment could reduce the levels of SUA, Smad1 protein and lipoprotein, with low adverse reactions. The clinical detection of SUA, Smad1 protein and lipoprotein levels can reflect the degree of renal injury in patients, and has certain guiding value for formulating treatment plans.

Key words： Type 2 diabetic nephropathy SGLT2 inhibitor Blood uric acid Smad1 protein Lipoprotein

基金资助:2019年度河北省医学课题研究计划,(编号:20191746)

通讯作者: 师苹

引用本文:

郝丽美, 宋薇, 王培, 亢玉兰, 陈亚平, 师苹. SGLT2抑制剂治疗2型糖尿病肾病效果及与SUA Smad1蛋白脂蛋白的相关性[J]. 河北医学, 2023, 29(5): 772-776.
HAO Limei, SONG Wei, WANG Pei, et al. Effectiveness of SGLT2 Inhibitor for Type 2 Diabetic Nephropathy and Its Correlation with SUA Smad1 Protein and Lipoprotein. HeBei Med, 2023, 29(5): 772-776.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.014 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/772

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