达格列净对2型糖尿病合并高血压患者醛固酮/肾素浓度比值的影响

Effect of dapagliflozin on aldosterone to renin ratio in patients with type 2 diabetes mellitus complicated with hypertension

目的探讨达格列净对2型糖尿病(T2DM)合并高血压患者醛固酮/肾素浓度比值(ARR)的影响。方法选取2019年9月至2020年12月就诊于北京怀柔医院内分泌科的T2DM合并高血压患者。测量并记录患者治疗前体重、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、尿酸、血浆肾素浓度、醛固酮水平等指标,并计算患者ARR。予患者达格列净治疗12周,再次收集相关血液学指标并计算患者ARR。采用配对t检验或Mann‐Whitney U检验对治疗前后ARR及相关指标进行比较。结果共纳入患者20例。其ARR在治疗前后分别为0.86(0.73,1.20)和0.95(0.72,1.32),治疗前后差异无统计学意义(Z=1.12,P=0.263)。达格列净治疗12周后,患者的FPG(Z=-3.62,P<0.001)、HbA1c(Z=-3.76,P<0.001)、体重(Z=-3.19,P=0.001)、尿酸(Z=-2.71,P=0.014)较治疗前均有下降,治疗前后差异均有统计学意义。结论达格列净对T2DM合并高血压患者的ARR无影响,其具有降低血糖、减轻体重、改善尿酸代谢等作用。

Objective To investigate the effect of dapagliflozin on aldosterone to renin ratio(ARR)in patients with type 2 diabetes mellitus(T2DM)complicated with hypertension.Methods Patients with T2DM and hypertension who were admitted to the Department of Endocrinology,Beijing Huairou Hospital from September 2019 to December 2020 were enrolled.Body weight,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),uric acid,plasma renin concentration,aldosterone level and other indicators were measured and recorded before treatment,and ARR was calculated.Patients were treated with dapagliflozin for 12 weeks,and hematologic indicators were collected again while ARR was also calculated.Paired t test or Mann-Whitney U test were used to compare the ARR and related indexes before and after treatment of dapagliflozin.Results A total of 20 patients were enrolled.ARR before and after treatment were 0.86(0.73,1.20)and 0.95(0.72,1.32),respectively.However,there was no significant difference between them(Z=1.12,P=0.263).After 12 weeks of dapagliflozin,FPG(Z=-3.62,P<0.001),HbA1c(Z=-3.76,P<0.001),body weight(Z=-3.19,P=0.001)and uric acid(Z=-2.71,P=0.014)decreased significantly compared with baseline.Conclusions Dapagliflozin has no effect on ARR in patients with T2DM complicated with hypertension,but it has good effects on reducing FPG,uric acid and weight loss.