Secondary Erythrocytosis Among Type 2 Diabetes Mellitus Patients With Hypogonadism Using Sodium-Glucose Cotransporter 2 Inhibitors and Testosterone Replacement Therapy

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM
Maharan Kabha, Hadar Dana, Sameer Kassem, Yoram Dekel, Hilla Cohen, Adnan Zaina
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引用次数: 0

Abstract

Hypogonadism is commonly linked to type 2 diabetes mellitus (T2DM), with testosterone replacement therapy (TRT) representing a key treatment option. Sodium glucose cotransporter-2 inhibitors (SGLT-2i) class is part of T2DM management. Both treatments can increase Hct, Hb and RBC levels with a potential risk for secondary erythrocytosis. This study compares Hct, RBC and Hb changes between T2DM patients treated with and without SGLT-2i and TRT for hypogonadism.

Methods

Data from Clalit Healthcare Services (2015–2023) was analysed from male T2DM patients with hypogonadism. Mixed linear regression assessed SGLT-2i effects on Hct, Hb and RBC levels, while generalised estimation equations were used to predict the proportion of patients with Hct > 54%.

Results

In total, 5235 male patients met the inclusion criteria, with 3146 in the SGLT-2i (+) group, while 2089 comprised the SGLT-2i (−) group. Mean age was 63.8 ± 11.0 years, mean Hct was 43.3% ± 4.4%, BMI was 30.8 ± 5.2 kg/m2 and eGFR was 84.9 ± 19.3 mL/min/1.73m2. The SGLT-2i (+) group demonstrated a statistically significant increase in Hct, Hb, and RBC after TRT initiation (p < 0.001). While the overall increase in Hct > 54% was not statistically significant after TRT initiation with OR = 1.85 [95% CI 0.96–3.67], p = 0.06. However, in the SGLT2i (+) group, it was significantly higher than for those in the SGLT2i (−) group, OR = 4.85 [95% CI 3.06–7.69], p = 0.02.

Conclusions

SGLT-2i and TRT co-administration are associated with an increased chance of developing secondary erythrocytosis in T2DM. Awareness and potential treatment discontinuation may prevent unnecessary investigations. Frequent monitoring of these parameters is essential.

Abstract Image

钠-葡萄糖共转运蛋白2抑制剂和睾酮替代治疗对2型糖尿病伴性腺功能减退患者继发性红细胞增多的影响
性腺功能减退通常与2型糖尿病(T2DM)有关,睾酮替代疗法(TRT)是一种关键的治疗选择。钠葡萄糖共转运蛋白-2抑制剂(SGLT-2i)类是T2DM治疗的一部分。两种治疗均可增加Hct、Hb和RBC水平,并有继发性红细胞增多的潜在风险。本研究比较了接受和不接受SGLT-2i和TRT治疗性腺功能减退的T2DM患者的Hct、RBC和Hb的变化。方法分析2015-2023年Clalit医疗服务中心收治的男性T2DM性腺功能减退患者的数据。混合线性回归评估SGLT-2i对Hct、Hb和RBC水平的影响,而广义估计方程用于预测Hct患者比例(54%)。结果共有5235例男性患者符合纳入标准,其中3146例为SGLT-2i(+)组,2089例为SGLT-2i(−)组。平均年龄63.8±11.0岁,平均Hct为43.3%±4.4%,BMI为30.8±5.2 kg/m2, eGFR为84.9±19.3 mL/min/1.73m2。SGLT-2i(+)组在TRT启动后Hct、Hb和RBC有统计学意义的增加(p < 0.001)。而TRT启动后Hct总升高54%,OR = 1.85 (95% CI 0.96-3.67), p = 0.06无统计学意义。然而,SGLT2i(+)组明显高于SGLT2i(-)组,OR = 4.85 [95% CI 3.06-7.69], p = 0.02。结论:SGLT-2i和TRT联合使用与T2DM患者继发性红细胞增多的几率增加有关。意识和潜在的治疗中断可以防止不必要的调查。经常监测这些参数是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Endocrinology, Diabetes and Metabolism
Endocrinology, Diabetes and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.00
自引率
0.00%
发文量
66
审稿时长
6 weeks
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