Effects of sodium‐glucose cotransporter 2 inhibitor, tofogliflozin, on the indices of renal tubular function in patients with type 2 diabetes

摘要

Aims: Little is known of the effect of sodium-glucosecotransporter 2 (SGLT2) inhibitorson the renal tubules. We investigated the effect of the SGLT2 inhibitor,tofogliflozin(TOFO) on renal tubular indices, according to the degree of albuminuria,in type 2 diabetes mellitus (T2DM) patients with preserved renal function.Materials and methods: A total of 988 patients, receiving TOFO, were enroled anddivided into 3 groups, based on the urine albumin-to-creatinineratio (UACR). Thetubular indices (urinary N-acetyl-beta-d-glucosaminidase[NAG]-to-creatinineandurinary beta-2microglobulin [beta2MG]-to-creatinineratios) and UACR were log-transformedin the correlation analysis.Results: Treatment with TOFO led to similar reductions in glycated haemoglobin(HbA1c) levels, from baseline to week 24, across all groups. The NAG level increasedin the normoalbuminuria group and decreased in the macroalbuminuria group significantly(P < .001, both), but did not change in the microalbuminuria group. Significantreductions in the UACR were observed in both microalbuminuria and macroalbuminuriagroups (P < .001, both). Significant negative correlations between changes inthe NAG and beta2MG levels and their corresponding baseline values were observedin all participants. The reduction in the UACR was negatively correlated with baselinelevels. The changes in the tubular indices were positively correlated with reductionsin the UACR across groups.Conclusions: Logarithmic reductions in the renal tubular indices, via SGLT2 inhibition,were observed in patients with T2DM. TOFO may not only improve the degreeof albuminuria but may also have protective effects on the tubules.