| Popis: |
Objective: To evaluate the effect of SGLT2 inhibitor (SGLT2i) on albuminuria, nephrin(NPH) and transforming-growth-factor-beta1(TGF-β1) expression in urine, glucose and lipid metabolism, low grade inflammation in type 2 diabetes(T2D ) patients.Methods: Sixty-eight patients with T2D were divided into three groups according urinary albumin-to-creatinine ratio(UACR), UACR in urine were measured as indications of podocyte injury and renal fibrosis. Low grade inflammation was assessed by the levels of IL-6,TNFα and hsCRP.Results: After 12 weeks SGLT2i treatment, UACR and NPH remarkably decreased, TGF-β1 dramatically increased in urine in T2D with microalbuminuria and macroalbuminuria groups, NPH(1.12[0.59, 1.29] vs 0.71[0.41, 1.07] ug/ml, P=0.022) and (1.29[0.99, 1.96] vs 0.93[0.57, 1.31]ug/ml, P=0.002), UTGF-β1(4.88±1.31 vs 7.27±1.21pg/ml, P˂0.001) and (4.30±1.34 vs 6.78±2.59pg/ml, P˂0.001), respectively. Stepwise multiple regression analyses show that TGF-β1, BMI, UACR, HDL-C, TNFα and IL-6 have significant effects on NPH levels.Conclusions: Our study showed that SGLT2i alleviate nephrin loss and enhance TGF-β1 excretion in urine in T2DM with albuminuria. The anti-albuminuric effect of SGLT2i could be attributed to mitigating podocyte apoptosis and attenuating renal fibrosis.Trial registration: This clinical trial has been registered on September 30, 2019 in ClinicalTrials.gov and the registry number is NCT04127084. |
