The effects of a sodium-glucose cotransporter 2 inhibitor on diabetic nephropathy and serum oxidized low-density lipoprotein levels

Abstract

Objective: To investigate the effect of an SGLT-2 inhibitor on diabetic nephropathy and serum oxidized low-density lipoprotein (ox-LDL) levels.

Patients and methods: We randomly divided 126 patients with diabetic nephropathy into the treatment group and control group. The 63 patients in the treatment group received an SGLT-2 inhibitor in addition to routine insulin therapy, while the control group received only insulin to control blood glucose. All laboratory indexes were recorded before and after treatment with the SGLT-2 inhibitor. The prognosis of patients was followed-up. Simultaneously, 63 healthy and BMI-matched in-patients were selected as the healthy control group. Peripheral blood samples were collected from all groups, and the levels of ROS were measured by ELISA.

Results: Renal function indexes such as urinary protein, creatinine, blood urea nitrogen, and glomerular filtration rate (GFR) were significantly higher with SGLT-2 inhibitor treatment compared with the control group (p<0.05). The fasting blood glucose level was not significantly increased before or after treatment (p>0.05). The levels of ROS in peripheral blood were significantly lower in the treatment group than in the control group (p<0.05). Observation at the 1-year follow-up showed that the average GFR was significantly higher in the treatment group than in the control group. Furthermore, the proportion of patients with stage 1-3 chronic kidney disease was significantly higher in the treatment group than in the control group (p<0.05).

Conclusions: The SGLT-2 inhibitor had a good therapeutic effect on renal function in patients with diabetic nephropathy, without having effects on fasting blood glucose. Additionally, it significantly delayed the progression of nephropathy. It is therefore worth clinical promotion.