Renal Handling of Ketones in Response to Sodium-Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes
Renal Handling of Ketones in Response to Sodium-Glucose Cotransporter 2 Inhibition in Patients With Type 2 Diabetes
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DOI：
10.2337/dc16-2724
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发表时间：
2017-06-01
期刊：
影响因子：
16.2
通讯作者：
Muscelli, Elza
中科院分区：
文献类型：
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作者：
Ferrannini, Ele;Baldi, Simona;Muscelli, Elza
药理学诱导的糖尿引起葡萄糖稳态和激素释放的适应性反应，包括血浆葡萄糖和胰岛素水平的降低，胰高血糖素释放的增加，脂解的增强和生酮的刺激，导致酮血症的增加。我们旨在评估肾脏对这些变化的反应。研究设计和方法我们测量了66例先前报道的2型糖尿病和保留肾功能（估计肾小球滤过率60 mL）的患者的空腹和餐后葡萄糖、β-羟基丁酸（β-HB）、乳酸和钠的尿排泄。min（-1）。1.73 m（-2））和基线时和恩格列净治疗后无糖尿病的对照受试者。
OBJECTIVEPharmacologically induced glycosuria elicits adaptive responses in glucose homeostasis and hormone release, including decrements in plasma glucose and insulin levels, increments in glucagon release, enhanced lipolysis, and stimulation of ketogenesis, resulting in an increase in ketonemia. We aimed at assessing the renal response to these changes.RESEARCH DESIGN AND METHODSWe measured fasting and postmeal urinary excretion of glucose, beta-hydroxybutyrate (beta-HB), lactate, and sodium in 66 previously reported patients with type 2 diabetes and preserved renal function (estimated glomerular filtration rate 60 mL . min(-1) . 1.73 m(-2)) and in control subjects without diabetes at baseline and following empagliflozin treatment.RESULTSWith chronic (4 weeks) sodium-glucose cotransporter 2 inhibition, baseline fractional glucose excretion (