Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control.
Long-term study of patients with type 2 diabetes and moderate renal impairment shows that dapagliflozin reduces weight and blood pressure but does not improve glycemic control.
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DOI：
10.1038/ki.2013.356
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发表时间：
2014-04
影响因子：
19.6
通讯作者：
List, James F.
中科院分区：
文献类型：
--
作者：
Kohan, Donald E.;Fioretto, Paola;Tang, Weihua;List, James F.
在糖尿病患者中，通过抑制钠-葡萄糖共转运蛋白-2来改善血糖取决于肾脏过滤葡萄糖的能力。达格列净是一种钠-葡萄糖共转运蛋白-2抑制剂，可降低糖尿病患者和正常或轻度肾功能受损患者的高血糖。在这项随机、双盲、安慰剂对照研究中，我们评估了252例控制不充分的2型糖尿病和中度肾功能损害患者每日服用达格列净的情况。24周后，主要终点HbA1c的平均变化与安慰剂无统计学差异（5 mg和10 mg剂量分别为- 0.41%和- 0.44%，安慰剂为- 0.32%）。5 mg和10 mg剂量组与基线相比的平均体重变化分别为- 1.54和- 1.89 kg，安慰剂组为+0.21 kg。与安慰剂组相比，达格列净组的平均收缩压和舒张压降低。104周后，13名接受达格列净治疗的患者和没有接受安慰剂治疗的患者发生骨折。在第1周时，平均血清肌酐升高，达格列净为5mg （+0.13 mg/dl）和10mg (+0.18 mg/dl)， 104周后没有进一步变化。各组的平均血清电解质没有变化，服用达格列净组的高钾血症发生率低于安慰剂组。因此，在中度肾功能损害患者中，达格列净不能改善血糖控制，但可以降低体重和血压。
In patients with diabetes, glycemic improvement by sodium-glucose cotransporter-2 inhibition depends on the kidney's ability to filter glucose. Dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, reduces hyperglycemia in patients with diabetes and normal or mildly impaired renal function. In this randomized, double-blind, placebo-controlled study we assessed daily treatment with dapagliflozin in 252 patients with inadequately controlled type 2 diabetes and moderate renal impairment. The primary endpoint, the mean change in HbA1c, was not statistically different from placebo after 24 weeks (−0.41% and −0.44% for 5- and 10-mg doses, respectively, and −0.32% for placebo). The mean weight change from baseline was −1.54 and −1.89 kg for the 5- and 10-mg doses, respectively, and +0.21 kg for placebo. The mean systolic and diastolic blood pressure decreased in the dapagliflozin groups compared to placebo. Through 104 weeks, 13 patients receiving dapagliflozin and no patients receiving placebo experienced bone fracture. At 1 week, the mean serum creatinine increased with dapagliflozin 5 mg (+0.13 mg/dl) and 10 mg (+0.18 mg/dl) and did not change further after 104 weeks. Mean serum electrolytes did not change in any group, and there were fewer episodes of hyperkalemia with dapagliflozin than placebo. Thus, in patients with moderate renal impairment, dapagliflozin did not improve glycemic control, but reduced weight and blood pressure.
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影响因子：
168.9
作者：
Bailey, Clifford J.;Gross, Jorge L.;List, James F.
通讯作者：
List, James F.
影响因子：
168.9
作者：
Tahrani, Abd A.;Bailey, Clifford J.;Barnett, Anthony H.
通讯作者：
Barnett, Anthony H.
影响因子：
3.6
作者：
Wood, IS;Trayhurn, P
通讯作者：
Trayhurn, P
影响因子：
16.2
作者：
Nauck MA;Del Prato S;Meier JJ;Durán-García S;Rohwedder K;Elze M;Parikh SJ
通讯作者：
Parikh SJ
影响因子：
15.9
作者：
KANAI, Y;LEE, WS;HEDIGER, MA
通讯作者：
HEDIGER, MA