Short-term effects of dapagliflozin on biomarkers of bone and mineral metabolism in patients with diabetic kidney disease: A prospective observational study

IF 2 4区医学 Q2 UROLOGY & NEPHROLOGY

Nefrologia Pub Date : 2024-11-01 DOI:10.1016/j.nefro.2024.06.002

Tugba Islek , Safak Mirioglu , Meltem Gursu , Rumeyza Kazancioglu , Metin Demirel , Sahabettin Selek , Omer Celal Elcioglu

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引用次数: 0

Abstract

Background

There is still a lack of information regarding the impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i) on bone and mineral metabolism in patients with diabetes and chronic kidney disease (CKD). Therefore, we aimed to investigate the effects of SGLT2i in a cohort of patients suffering from diabetic kidney disease (DKD).

Methods

In this prospective observational study, patients with type 2 diabetes and biopsy-proven diabetic nephropathy or presumptive DKD with eGFR levels ≥20 ml/min/1.73m2 and 25-OH vitamin D levels ≥20 ng/dl were included. 41 used SGLT2i (study group) and 39 continued their current treatment regimens (control group). Serum FGF-23, sclerostin, osteoprotegerin (OPG), and hydroxyproline levels were measured at baseline, 1 month and 3 months after treatment.

Results

Mean age of all patients was 67 ± 9.3 years, and 48 (60%) were female. All patients in the study group used dapagliflozin. Taking into account the renal functions at the commencement of the study, the eGFR values for the study group and the control group were 51.2 ± 15.6 and 44.6 ± 16.9 ml/min/1.73m², respectively (p = 0.01). After three months, these values were observed to be 47.4 ± 16.7 and 44.3 ± 18.8 ml/min/1.73m² (p = 0.43), respectively. At baseline, OPG levels were higher in the study group (p = 0.025) but there were no differences between the groups in terms of FGF-23 and sclerostin levels (p = 0.670 and p = 0.467, respectively). Levels of OPG, FGF-23, and sclerostin significantly decreased throughout 3 months of treatment with dapagliflozin (p < 0.001 for all). Hydroxyproline levels also declined but did not reach to statistical significance (p = 0.075). Multiple linear regression models revealed that treatment with SGLT2i was associated with the change in levels of sclerostin (β=0.303, p = 0.011) and OPG (β=0.210, p = 0.010), but not with FGF-23 (β=0.089, p = 0.150).

Conclusions

FGF-23, sclerostin and OPG levels significantly declined after treatment with dapagliflozin for 3 months.

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达帕格列净对糖尿病肾病患者骨和矿物质代谢生物标志物的短期影响：前瞻性观察研究

背景关于钠-葡萄糖共转运体 2 抑制剂（SGLT2i）对糖尿病和慢性肾病（CKD）患者骨质和矿物质代谢的影响，目前仍缺乏相关信息。方法在这项前瞻性观察研究中，纳入了经活检证实患有糖尿病肾病或推测患有糖尿病肾病且 eGFR 水平≥20 ml/min/1.73m2 和 25-OH 维生素 D 水平≥20 ng/dl 的 2 型糖尿病患者。41 人使用 SGLT2i（研究组），39 人继续目前的治疗方案（对照组）。结果所有患者的平均年龄为 67 ± 9.3 岁，其中 48 人（60%）为女性。研究组所有患者均使用达帕格列净。考虑到研究开始时的肾功能，研究组和对照组的 eGFR 值分别为 51.2 ± 15.6 和 44.6 ± 16.9 毫升/分钟/1.73 平方米（p = 0.01）。三个月后，观察到这些数值分别为 47.4 ± 16.7 和 44.3 ± 18.8 毫升/分钟/1.73 平方米（p = 0.43）。基线时，研究组的 OPG 水平更高（p = 0.025），但两组的 FGF-23 和硬骨素水平没有差异（分别为 p = 0.670 和 p = 0.467）。在使用达帕格列净治疗的 3 个月期间，OPG、FGF-23 和硬骨蛋白的水平显著下降（均为 p < 0.001）。羟脯氨酸水平也有所下降，但未达到统计学意义（p = 0.075）。多元线性回归模型显示，SGLT2i治疗与硬骨生成素（β=0.303，p=0.011）和OPG（β=0.210，p=0.010）水平的变化有关，但与FGF-23（β=0.089，p=0.150）无关。

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来源期刊

Nefrologia 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

7.70%

发文量

148

审稿时长

47 days

期刊介绍： Nefrología is the official publication of the Spanish Society of Nephrology. The Journal publishes articles on basic or clinical research relating to nephrology, arterial hypertension, dialysis and kidney transplants. It is governed by the peer review system and all original papers are subject to internal assessment and external reviews. The journal accepts submissions of articles in English and in Spanish languages.