| Objective To observe the changes of blood glucose,blood pressure,body mass index,lipids and kidney-related indexes in patients with early stage nephropathy of type 2diabetes mellitus after treatment with liraglutide,dagliflozin and the combination of the two.Methods One hundred and twenty patients with type 2 diabetic nephropathy with poor glycemic control were divided into dagliflozin group,liraglutide group,dagliflozin combined with liraglutide group and control group（i.e.,no dagliflozin or liraglutide）,30 patients in each group.Fasting blood glucose（FBG）,2h postprandial blood glucose（2h PG）,glycated hemoglobin（Hb A1c）,systolic blood pressure（SBP）,diastolic blood pressure（DBP）,body mass index（BMI）,triglycerides（TG）,total cholesterol（TC）,serum creatinine（Scr）,random urinary albumin to creatinine ratio（UACR）,serum cystatin C（Cys C）,urinary N-acetyl-β-D aminoglucosidase（NAG）,α1-microglobulin（α1-MG）,β2-microglobulin（β2-MG）and other indicators.Results In terms of blood glucose: after 24 weeks of treatment,FBG and Hb A1 c levels in all four groups were lower than before treatment（P < 0.05）,and the difference between groups was not statistically significant（P > 0.05）;2h PG in the liraglutide group decreased from（17.36 ± 3.72）to（10.39 ± 3.93）,and the decrease was greater than that in the control group after treatment（P < 0.05）;body index: BMI decreased from（23.38±2.71）to（18.65±2.65）in the daglitazone group,and the decrease was greater than that in the control group after treatment than before treatment（P<0.05）;BMI decreased from 19.12（18.87,21.41）to 15.75（15.12,17.58）in the liraglutide group,and the decrease was greater than that in the The BMI in the daglitazone combined with liraglutide group decreased from 19.91（17.67,23.6）to 14.38（13.08,17.6）,which was significantly lower than that in either the daglitazone or liraglutide groups（P < 0.05）;for lipids: TG decreased from 1.12（0.8,1.73）to 0.6（0.26,1.28）in the liraglutide group.1.28)and TC decreased from（4.8±1.28）to（3.8±1.44）in the liraglutide group,and both decreased more than the control group after treatment（P<0.05）;for blood pressure: DBP decreased from（75.73±9.87）to（74.87±9.91）in the dagliflozin group,and decreased more than the control group after treatment（P<0.05）;for renal-related As for renal-related indicators,UACR decreased from 46.72（33.17,89.5）to 27.49（21.31,78.69）,NAG decreased from 11（9.48,14.2）to 6.86（4.3,8.93）,Cys C decreased from（1.15±0.3）to（0.81±0.3）,α1-MG decreased from 6.77（6.22,9.5）to 2.54（1.16,4.75）,β2-MG from 0.37（0.33,0.6）to 0.13（0.11,0.23）,which decreased more than the control group after treatment than before treatment（P < 0.05）;UACR decreased from（109.92 ± 65.01）to（93.97 ± 61.53）,NAG decreased from（14.16±3.57）to（9.9±4.04）,Cys C decreased from（1.01±0.23）to（0.71±0.22）,α1-MG decreased from（12.63±5.41）to（8.87±5.72）,β2-MG decreased from 0.54（0.41,0.59）to 0.17（0.13,0.24）,which decreased more than the control group after treatment than before treatment（P < 0.05）;UACR decreased from 37.26（33.96,48.38）to 22.7（19.75,31.67）,NAG decreased from 10.6（8.98,12.7）to 4.25（3.46,6.5）in the daglitazone combined with liraglutide group,and Cys C decreased from 0.99（0.68,1.07）to 0.34（0.26,0.39）,α1-MG decreased from 6.93（5.8,9.4）to 2.34（1.24,4.98）,and β2-MG decreased from0.3（0.24,0.89）to 0.14（0.12,0.34）,which were all significantly lower than those in the daglitazone or liraglutide groups（P < 0.05）.（P < 0.05）.It is concluded that both dagliflozin and liraglutide can reduce the excretion of urinary albumin and delay the progression of nephropathy in patients with early type 2 diabetic nephropathy,and the renoprotective effect of dagliflozin combined with liraglutide is more significant. |
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