8月23日讯 /生物谷BIOON/ --最近一项研究表明一类新型口服抗糖尿病药物除了可以帮助病人降低血糖水平，或还可帮助保护病人肾脏健康。相关研究结果发表在国际学术期刊Journal of the American Society of Nephrology上。
SGLT2抑制剂药物通过抑制肾脏SGLT2功能增加葡萄糖向尿液中的排放从而达到降低血糖的效果。除此之外，这种新型的抗糖尿病药物还可以帮助降低血压和体重。但是到目前为止SGLT2抑制剂药物对肾脏功能的影响还没有得到完整评估。
来自荷兰的研究人员对一项为期2年的随机对照试验数据进行了分析，对比了一种SGLT2抑制剂药物canagliflozin和另外一种叫做glimepiride的降糖药物，glimepiride属于一种磺脲类药物，通过促进胰岛细胞释放胰岛素发挥作用。该临床试验共包括1450名服用二甲双胍的2型糖尿病患者，这些患者被随机分为几组：第一组每天服用100mg canagliflozin，第二组每天服用300mg canagliflozin，第三组服用6～8mg glimepiride。通过估算肾小球滤过率评估肾脏功能。
研究结果表明canagliflozin对肾脏功能的保护作用好于glimepiride，而上述几组病人的血糖下降水平比较接近。
“由于canagliflozin和glimepiride之间在血糖控制方面的差异不大，因此基于分析结果我们认为canagliflozin对肾脏功能的保护作用可能与血糖控制无关。许多糖尿病病人都存在肾脏功能丧失的风险，因此这项研究的发表由非常重要的意义，canagliflozin可能为这些病人提供了一种更好的治疗选择。”Dr. Heerspink这样表示。
领域内专家认为SGLT2抑制剂药物对肾脏的保护作用表明这类药物可能有助于降低心血管事件风险，如心脏病发作和中风。SGLT2抑制剂药物为肾脏和心血管系统带来的好处或将导致医生和内分泌专家在对2型糖尿病患者进行治疗时对这些药物的使用更加频繁。当然也要根据药物副作用，患者经济情况，替代药物和病人体质进行适当选择。（生物谷）
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Canagliflozin Slows Progression of Renal Function Decline Independently of Glycemic Effects
Hiddo J. L. Heerspink*, Mehul Desai , Meg Jardine , Dainius Balis , Gary Meininger and Vlado Perkovic
Sodium-glucose cotransporter 2 inhibition with canagliflozin decreases HbA1c, body weight, BP, and albuminuria, implying that canagliflozin confers renoprotection. We determined whether canagliflozin decreases albuminuria and reduces renal function decline independently of its glycemic effects in a secondary analysis of a clinical trial in 1450 patients with type 2 diabetes receiving metformin and randomly assigned to either once-daily canagliflozin 100 mg, canagliflozin 300 mg, or glimepiride uptitrated to 6–8 mg. End points were annual change in eGFR and albuminuria over 2 years of follow-up. Glimepiride, canagliflozin 100 mg, and canagliflozin 300 mg groups had eGFR declines of 3.3 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], 2.8 to 3.8), 0.5 ml/min per 1.73 m2 per year (95% CI, 0.0 to 1.0), and 0.9 ml/min per 1.73 m2 per year (95% CI, 0.4 to 1.4), respectively (P 0.01 for each canagliflozin group versus glimepiride). In the subgroup of patients with baseline urinary albumin-to-creatinine ratio ≥30 mg/g, urinary albumin-to-creatinine ratio decreased more with canagliflozin 100 mg (31.7%; 95% CI, 8.6% to 48.9%; P=0.01) or canagliflozin 300 mg (49.3%; 95% CI, 31.9% to 62.2%; P 0.001) than with glimepiride. Patients receiving glimepiride, canagliflozin 100 mg, or canagliflozin 300 mg had reductions in HbA1c of 0.81%, 0.82%, and 0.93%, respectively, at 1 year and 0.55%, 0.65%, and 0.74%, respectively, at 2 years. In conclusion, canagliflozin 100 or 300 mg/d, compared with glimepiride, slowed the progression of renal disease over 2 years in patients with type 2 diabetes, and canagliflozin may confer renoprotective effects independently of its glycemic effects.
