Effect Of Empagliflozin On Urine Albumin-to-creatinine Ratio And Cystatin C In Patients With Type 2 Diabetes

Objective:The results of the EMPA-REG study not only confirmed the cardiovascular benefits of empagliflozin on patients with type 2 diabetes mellitus(T2DM)combined with cardiovascular disease,but also showed that empagliflozin could reduce the risk of worsening kidney disease.So,could the renal-protective effects of enpagliflozin be observed in the real world?A retrospective analysis was used to observe the effects of empagliflozin on urine albumin-to-creatinine ratio(UACR)and cystatin C(Cys-C)in patients with T2DM in the study in order to explore the renal protective effects and possible mechanisms of empagliflozin in T2DM.Methods:The clinical data of T2DM patients who were admitted to the Second Hospital of Hebei Medical University from December 2019 to December 2020 were collected for retrospective analysis,and 42 were selected through 1:1 matching of propensity scores.According to different treatment measures,they were divided into observation group(Emp)and control group(Con),including 21,respectively.All the selected patients were treated for 12weeks.Emp group:empagliflozin 10mg 1/d±other hypoglycemic drugs(except GLP-1R agonists and DPP4 inhibitors);Con group:DPP4 inhibitors±other hypoglycemic drugs(except GLP-1R agonist and SGLT2i),other hypoglycemic drugs and combination drugs for basic diseases used in the two groups were matched by propensity scores,and there was no statistical difference.Height,weight,systolic blood pressure(SBP),systolic blood pressure(DBP),fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),blood urea nitrogen(BUN),blood uric acid(UA),blood creatinine(Scr),blood cystatin C(Cys-C),total cholesterol(TC),triglycerides(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),morning urine albumin/creatinine ratio(UACR)were measured at baseline and after treatment.Body mass index(BMI)and glomerular rate filtration(e GFR)were calculated.Normally distributed measurement data were expressed as mean±standard deviation(χ±s),t-test was used;Non-normally distributed measurement data were expressed as median and interquartile range[M(Q_L,Q_U)],rank sum test was used for comparison between the groups.The changes of each index after treatment between the groups were compared.Results:1.After treatment,FBG、Hb A1c、TG、LDL-C、SBP、DBP、UA、UACR and Cys-C of the two groups were lower than those at baseline,and the difference was statistically significant(P<0.01,P<0.05);the greater reduction in SBP、Hb A1c、UA、UACR was showned in Emp group,and the difference was statistically significant(P<0.01,P<0.05);There was no significant difference in the reduction in Cys-C between groups(P>0.05).After treatment,the BMI of Emp group was lower than that at baseline,and the difference was statistically significant(P<0.01),while the BMI of Con group did not change significantly(P>0.05).There was no significant difference in the changes in BMI between groups.(P<0.01).2.There were no adverse events such as hypoglycemia,liver damage,genitourinary infection and pancreatitis occurred in the two groups within 12weeks.Conclusion:Empagliflozin not only has effects of glycemic control and weight loss,but also could lower blood pressure and the level of uric acid.Meanwhile,it could significantly reduce urine protein and maybe play a role in renal protection.