目的:探讨SGLT2i对男性初诊2型糖尿病(T2D)患者GH/IGF1轴的影响。
方法:招募60例新诊断为T2D的男性患者,基线评估后随机分配到二甲双胍+SGLT2i组或二甲双胍组。所有患者接受标准的生活方式干预,并在治疗前和治疗12周后获得血液指标。
结果:二甲双胍+SGLT2i治疗12周后,患者FPG(空腹血糖)有显著改善,HBA1c,HOMA-IR,HOMA-β,TyG(甘油三酯-葡萄糖)指数和UACR(P<0.05)。IGF1(P=0.01)和IGF1/IGFBP3比值(P<0.01)均显著增加,而GH和IGFBP3无明显变化。当比较二甲双胍+SGLT2i组与二甲双胍组,SGLT2i显著改善了HOMA-IR[P=0.04],和升高的IGF1/IGFBP3比率[P=0.04],SGLT2i显示出IGF1增加的趋势(P=0.10),但这在统计上没有意义。对GH和IGFBP3没有影响。相关性分析显示血IGF1与FPG呈负相关,HBA1c,HOMA-IR,TyG指数与IGFBP3呈正相关。回归分析显示FPG和睾酮对血IGF1水平有负面影响,HOMA-IR无明显影响。
结论:在新诊断为T2D的男性患者中,SGLT2i可以增加IGF1/IGFBP3比,缓解胰岛素抵抗,但对GH和IGF1水平无显著影响。此外,我们的研究表明,二甲双胍+SGLT2i治疗导致血IGF1水平升高,改善胰岛素抵抗,提示IGF1在新诊断的T2D中的潜在有益作用。
OBJECTIVE: To investigate the effect of
SGLT2i on the GH/IGF1 axis in male patients with newly diagnosed type 2 diabetes (T2D).
METHODS: Sixty male patients with newly diagnosed T2D were recruited, and randomly assigned to Metformin+
SGLT2i group or Metformin group after baseline assessment. All patients received standard lifestyle interventions, and blood indices were obtained before and after 12 weeks of treatment.
RESULTS: After 12 weeks of treatment with Metformin+
SGLT2i, there were noteworthy improvements in patients\' FPG (Fasting plasma glucose), HBA1c, HOMA-IR, HOMA-β, TyG (Triglyceride-glucose) index and UACR (P < 0.05). Both IGF1 (P = 0.01) and the IGF1/IGFBP3 ratio (P < 0.01) considerably increased, while GH and IGFBP3 did not show significant changes. When comparing Metformin+
SGLT2i group to Metformin group,
SGLT2i significantly improved HOMA-IR [P = 0.04], and elevated IGF1/IGFBP3 ratio [P = 0.04], SGLT2i showed a tendency of increasing IGF1 (P = 0.10), but this was not statistically meaningful. There was no effect on GH and IGFBP3. Correlation analysis showed that blood IGF1 was negatively correlated with FPG, HBA1c, HOMA-IR, TyG index and positively correlated with IGFBP3. Regression analysis indicated that FPG and testosterone had a negative effect on blood IGF1 level, while HOMA-IR had no obvious effect.
CONCLUSIONS: In male patients with newly diagnosed T2D, SGLT2i can increase IGF1/IGFBP3 ratio, alleviate insulin resistance, but has no significant effect on GH and IGF1 levels. Additionally, our study showed that Metformin+
SGLT2i treatment resulted in an increase in blood IGF1 levels and improved insulin resistance, suggesting a potentially beneficial role of IGF1 in newly diagnosed T2D.