禁食基质预测了CREDENCE试验中的慢性病进展,这些患者患有2型糖尿病
Ele Ferrannini1, Simona Baldi2, Maria Tiziana Scozzaro2
1CNR (National Research Council) Institute of Clinical Physiology, Pisa, Italy.
JCI insight
|December 20, 2024
概括
较高的基线乳酸和自由脂肪酸 (FFAs) 与慢性病 (CKD) 进展的减缓和2型糖尿病 (T2D) 患者的更好的心血管结果有关. 卡纳格利弗洛辛治疗通过增加基质水平来增强这些保护作用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 代谢研究研究 代谢研究
背景情况:
- 已知-葡萄糖共运输体2 (SGLT2) 抑制剂可减缓慢性病 (CKD) 的进展.
- 在2型糖尿病 (T2D) 和白尿性CKD患者中,循环基质配置和CKD进展之间的关系仍然是研究领域.
研究的目的:
- 在CREDENCE试验中,调查循环基质水平与CKD进展和T2D患有albuminuricCKD的T2D患者的心血管结局之间的关联.
- 评估卡纳格利弗洛辛治疗对这些基质的影响及其对临床结果的预测价值.
主要方法:
- 在CREDENCE试验中,来自2543名患者的血样本在基线和随机对卡纳格利弗洛辛或安慰剂随机对照后1年内被分析为禁食基质.
- 使用多变量Cox模型来评估基质与CKD进展,心力衰竭住院/心血管疾病死亡 (hHF/CVD) 和死亡率的关联.
主要成果:
- 基线乳酸和自由脂肪酸 (FFA) 的升高独立与慢性瘤进展和hHF/CVD风险降低有关.
- 卡纳格利弗洛辛治疗增加了FFF,糖醇,β-基酸和酸乙酸的血水平.
- 从基线到1年基质水平的变化预测了CKD进展和hHF/CVD相对风险的显著降低,无论治疗分配如何.
结论:
- 基本能量基质在影响T2D患者的长期主要结果方面发挥了选择性作用.
- 卡纳格利弗洛辛治疗通过增加这些基质的循环水平来放大这些基质的有益作用,这表明其脏保护和心脏保护作用的潜在机制.
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