Effects of dapagliflozin on intima-medial thickness of carotid artery in type 2 diabetic mellitus patients

doi:10.12092/j.issn.1009-2501.2018.07.015

Abstract

Abstract:

AIM: To assess the effects of dapagliflozin on intima-medial thickness(IMT) of carotid artery in type 2 diabetic mellitus patients. METHODS: A total of 113 patients of type 2 diabetic mellitus were divided into dapagliflozin group (58 cases) and control group (55 cases).All patients were recruited in this randomized trial. Based on the intervention of life style，all patients undertook oral aspirin 0.1 g/d and atorvastatin 20 mg/d. The dapagliflozin group was given dapagliflozin 10 mg every day, while the control group was given other oral antidiabetic drug with/without insulin therapy. Course of treatment was 24 weeks. The various biochemical indices and carotid artery IMT were detected and the data were analyzed and compared between the two groups. RESULTS: In the dapagliflozin group, the IMT decreased after dapagliflozin therapy (P＜0.01).In the control group, the distinction of IMT had not statistical significant between before and after therapy (P＞0.05).There were significant differences in carotid artery IMT between the two groups after therapy (P＜0.01), while there was no statistically significant difference between decreased blood sugar and blood pressure level (P＞0.05). CONCLUSION: Dapagliflozin can decrease the IMT in patients with type 2 diabetic mellitus, which is closely related to cardiovascular benefit in patients with type 2 diabetic mellitus.

Key words: dapagliflozin, intima-media thickness, type 2 diabetes mellitus

CLC Number:

R587.1

YE Shengkai, WEN Jie, LIU Weiping, REN Xia, CHEN Haiying, DU Ying, LI Xue, ZHANG Ru, YU Li, ZHANG Biying. Effects of dapagliflozin on intima-medial thickness of carotid artery in type 2 diabetic mellitus patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(7): 814-819.

References

［1］刘川,马淑,杨伟.老年糖尿病合并冠心病患者血清抵抗素与代谢指标的相关性研究［J］.疑难病杂志,2016, 15(5):465-471.

［2］马红雨,董磊,孙立美,等. 维生素D与糖尿病肾病相关作用机制的研究进展［J］.空军医学杂志, 2017,33(4):283-285.

［3］Li MW. Prevalence and ethnic pattern of diabetes and prediabetes in China in 2013［J］.JAMA, 2017, 317(24):2515-2523.

［4］李盈盈,彭莉,毕晨超.体力活动对中老年2型糖尿病患者身体状况的影响［J］.保健医学研究与实践, 2017,14(4):105-107.

［5］刘畅,姜道利,刘小芳,等.链脲佐菌素诱导2型糖尿病大鼠合并脑缺血再灌注损伤模型优化方法的研究［J］.中国临床药理学与治疗学, 2017,22 (5):518-525.

［6］Ross R.The pathogenesis of atherosclerosis: a perspective for the 1990［J］. Nature,1993,362:8012-8021.

［7］史尔兰,李忠东,孙健,等.银杏叶提取物抑制人冠状动脉内皮细胞中的NF-κB表达及VAP-1、IL-6生成的研究［J］.空军医学杂志, 2016,32(4):242-245.

［8］Lee TM,Chang NC,Lin SZ. Dapagliflozin, a selective SGLT2 Inhibitor, attenuated cardiac fibrosis by regulating the macrophage polarization via STAT3 signaling in infarcted rat hearts ［J］. Free Radic Biol & Med, 2017,104:298-310.

［9］Mikhail K, Matthew AC, Matthew ZF, et al. Lower risk of heart failure and death in patients initiated on sodium-glucose cotransporter-2 inhibitors versus other glucose-lowering drugs［J］. Circulation,2017,136:249-259.

［10］金启辉,鲍晓峰,谷卫.胱抑素C与早期2型糖尿病患者颈动脉内膜中层厚度的相关性［J］.中华内分泌代谢杂志,2012, 28(1):29-31.

［11］张梅,张运,高月花,等.颈动脉及股动脉内膜-中膜层厚度正常值的对比研究［J］.中国医学影像技术,2002, 18(1):32-34.

［12］盛励,黄新梅,徐炯,等. 2型糖尿病患者颈动脉内膜中层厚度与轻度认知功能障碍的关系［J］.临床内科杂志, 2017,34(4):239-241.

［13］Kasami R,Kaneto H,Katakami N,et al.Relationship between carotid intima-media thickness and the presence and extent of coronary stenosis in type2 diabetic patients with carotid atherosclerosis but without historyof coronary artery disease［J］.Diabetes Care,2011,34:468-470.

［14］郑霄,胡晓晟.瑞舒伐他汀对高血压伴颈动脉硬化的疗效及对外周巨噬细胞极化的影响［J］.中国临床药理学与治疗学, 2017,22 (9):1035-1039.

［15］曹亚英,孙可欣,项骁,等.2型糖尿病患者血糖控制与颈动脉内膜中层厚度的相关性研究［J］.中华疾病控制杂志,2016,20(7):647-652.

［16］蒋玲玲.2型糖尿病颈动脉内膜中层厚度的相关因素研究［J］.糖尿病新世界,2017,20(1):50-51.

［17］隋淼,张弢,杨晓辉,等. 老年2型糖尿病患者血尿酸水平与颈动脉硬化间的关系研究［J］.检验医学与临床,2017,14(3):413-415.

［18］Holman RR,Coleman RL, Chan JCN, et al. Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trial［J］. Lancet Diabetes Endocrinol,2017, 5(11):877-886.

［19］Polak JF, Pencina MJ, Pencina KM, et al. Carotid-wall intima-media thickness and cardiovascular events［J］. N Engl J Med,2011,365(3):213-221.

［20］Cefalu WT, Leiter LA, de Bruin TW,et al.Dapagliflozin's effects on glycemia and cardiovascular risk factors in high-risk patients with type 2 diabetes: a 24-week, multicenter, randomized, double-blind, placebo-controlled study with a 28-week extension［J］.Diabetes Care,2015,38(7):1218-1227.

［21］Leiter LA, Cefalu WT, de Bruin TW,et al. Dapagliflozin added to usual care in individuals with type 2 diabetes mellitus with preexisting cardiovascular disease: a 24-week, multicenter, randomized, double-blind, placebo-controlled study with a 28-week extension［J］. J Am Geriatr, 2014, 62(7):1252-1262.

［22］Weber MA, Mansfield TA, Cain VA,et al.Blood pressure and glycaemic effects of dapagliflozin in patients with type 2 diabetes on combination antihypertensive therapy: a randomised, double-blind, placebo-controlled, phase 3 study［J］. Lancet Diabetes Endocrinol, 2016, 4(3):211-220.

［23］Ishibashi Y, Matsui T, Yamagishi S.Tofogliflozin, A highly selective inhibitor of SGLT2 blocks proinflammatory and proapoptotic effects of glucose overload on proximal tubular cells partly by suppressing oxidative stress generation［J］. Horm Metab Res, 2016, 48(3):191-195.

［24］Wilding JP,Woo V,Soler NG,et al.Long-term efficacy ofdapagliflozin in patients with type 2 diabetes mellitus receivinghigh doses of insulin［J］.Ann Intern Med,2012,156(6):405-415.

［25］Kosiborod M, Lam CSP, Kohsaka S, et al.Lower cardiovascular risk associated with SGLT-2i in >400,000 patients: the CVD-REAL 2 study［J］. J Am Coll Cardiol (in press). DOI: 10.1016/j.jacc.2018.03.009.

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