摘要
目的:研究钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)卡格列净在肾病综合征(NS)模型大鼠治疗过程中对骨代谢的影响。方法:取42只雄性SD大鼠,随机抽取6只为NG(对照)组,其余36只通过尾静脉注射阿霉素造模并分为6组:MG(模型)组、PG(泼尼松)组、LCG(低剂量卡格列净)组、HCG(高剂量卡格列净)组、LPCG(低剂量卡格列净+泼尼松)组和HPCG(高剂量卡格列净+泼尼松)组,每组6只。每日清晨定时灌胃,疗程6周。治疗结束行24h尿蛋白定量(24 h-UTP)、尿钙、尿磷、血清白蛋白(ALB)、血钙、血磷、碱性磷酸酶(ALP)及骨密度检测。结果:与NG组比较,MG、PG、HCG及HPCG组ALP水平升高,各药物治疗组骨盆骨密度降低,PG、HPCG组全身骨盐量以及躯干和肋骨的骨密度下降。与MG组比较,各药物治疗组均出现24 hUTP水平降低,ALB水平升高;LPCG和HPCG组尿钙水平升高;PG组血磷水平升高。结论:卡格列净可有效降低尿蛋白、升高ALB,可用于NS治疗,治疗过程中可导致骨盆骨密度下降。高剂量卡格列净或与泼尼松联用时引起钙磷代谢异常、ALP升高和骨密度下降范围扩大,增加了骨质疏松的风险。
Objective:To study the effect of sodium glucose cotransporter 2 inhibitor(SGLT2i)canagliflozin on bone metabolism in rats with nephrotic syndrome(NS).Methods:There were 42 male SD rats in total,among which 6 rats were randomly selected as NG group,and the other 36 rats were injected with adriamycin through tail vein for modeling and were randomly divided into 6groups,i.e.,MG group(model group),PG group(prednisone group),LCG group(low-dose canagliflozin group),HCG group(highdose canagliflozin group),LPCG group(low-dose canagliflozin+prednisone group)and HPCG group(high-dose canagliflozin+prednisone group),with 6 rats in each group.The rats were treated by regular gavage every morning for 6 weeks.At the end of treatment,24 h-UTP,urinary calcium,urinary phosphorus,serum albumin(ALB),blood calcium,blood phosphorus,alkaline phosphatase(ALP)and bone mineral density were measured.Results:Compared with NG group,ALP level increased in MG,PG,HCG and HPCG groups,and pelvic bone mineral density decreased in all drug treatment groups,PG and HPCG group caused the decrease of systemic bone mineral content,trunk and rib bone mineral density.Compared with MG group,24h-UTP level decreased and ALB level increased in all drug treatment groups.Urinary calcium level increased in LPCG and HPCG groups.Serum phosphorus level increased in PG group.Conclusion:canagliflozin can effectively reduce urinary protein and increase ALB.So it can be used in the treatment of NS,but it can cause the decrease of pelvic bone mineral density.High-dose canagliflozin or its combination with prednisone can also cause abnormal calcium and phosphorus metabolism,increase ALP,expand the range of bone mineral density decline,and increase the risk of osteoporosis.
作者
洪文娟
邹久林
余卓锐
成家茂
何敏华
Hong Wenjuan;Zou Jiulin;Yu Zhuorui;Cheng Jiamao;He Minhua(Clinical College,Dali University,Dali,Yunnan 671000,China;The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Pre-clinical College,Dali University,Dali,Yunnan 671000,China)
出处
《大理大学学报》
2022年第4期21-25,共5页
Journal of Dali University
关键词
钠-葡萄糖协同转运蛋白2抑制剂
骨密度
钙磷代谢
肾病综合征
sodium glucose cotransporter 2 inhibitor
bone mineral density
calcium and phosphorus metabolism
nephrotic syndrome
作者简介
第一作者:洪文娟,主治医师,主要从事肾脏病临床与基础研究;通信作者:何敏华,教授,E-mail:dlhmh@163.com。
