Impact of dapagliflozin on Hcy and its efficacy in diabetic nephropathy elderly patients with hypertension
10.3969/j.issn.1009-0126.2024.05.007
- VernacularTitle:达格列净对老年2型糖尿病肾病合并高血压患者同型半胱氨酸的影响及疗效分析
- Author:
Weiqiang XU
1
;
Tong CHEN
;
Lifang ZHANG
;
Fanqi GENG
;
Jietao ZHANG
Author Information
1. 266000 青岛大学附属医院全科医学科
- Keywords:
diabetic nephropathies;
hypertension;
homocysteine;
logistic models;
therapy;
dapag-liflozin
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(5):508-512
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect and clinical efficacy of dapagliflozin on homocysteine(Hcy),uric acid(UA),and cystatin C(Cys C)in elderly patients with type 2 diabetes mellitus(T2DM)complicated by nephropathy and hypertension.Methods A total of 292 patients diag-nosed with T2DM nephropathy and hypertension admitted to our hospital between December 2022 and June 2023 were retrospectively recruited,and based on their medication regimens,they were divided into dapagliflozin group(147 cases)and control group(145 cases).After all of them were followed up for 3 months,the serum levels of Hcy,UA,cys C,urinary microalbumin/urinary creatinine ratio(UACR),estimated glomerular filtration rate(eGFR),and other metabolism-related indicators were measured and compared before and after treatment.Pearson correlation analysis was used to determine the correlation between Hcy and UA,while logistic regression analysis was employed to identify risk factors for proteinuria among the patients with T2DM ne-phropathy and hypertension.Results After treatment,the BMI,SBP,DBP,FBG,glycosylated Hb,TC,TG,LDL-C,UA,Cys C,Hcy,insulin resistance index(HOMA-IR),and UACR were all decreased in comparison to their levels before treatment(P＜0.05).Dapagliflozin treatment resul-ted in more significant declines in BM1,FBG,LDL-C,UA,Cys C,Hcy,HOMA-IR,and UACR when compared with the control group(P＜0.05,P＜0.01).Pearson correlation analysis revealed that the relationship between Hcy and UA was positively correlated across the entire population(r=0.560,P＜0.01),as well as among males(r=0.510,P＜0.01)and females(r=0.640,P＜0.01).Multivariate logistic regression analysis identified female gender,diabetic peripheral neu-ropathy,TC,eGFR,and Hcy ≥15 μmol/L as independent risk factors for proteinuria among eld-erly patients with T2DM nephropathy and hypertension(P＜0.05,P＜0.01).Conclusion Dapa-gliflozin,a novel antidiabetic agent,may offer further renal protection by lowering Hcy and UA levels in patients with T2DM nephropathy and hypertension.It can potentially decelerate the pro-gression of proteinuria and improve patient's outcomes.
