Analysis on the Influencing Factors of Disease Progression in Patients with Early Diabetes Nephropathy Treated with SGLT2 Inhibitor

Wang Yingfang; Yao Yi; Liu Lu

doi:10.3969/j.issn.1004-5775.2026.01.008

Abstract：Objective:To analyze the influencing factors of disease progression in patients with early diabetes nephropathy treated with sodium glucose cotransporter 2(SGLT2)inhibitors.Methods:The data of 148 patients with diabetes nephropathy admitted to the Nanyang Central Hospital from June 2022 to June 2023 were collected retrospectively.All patients received routine intervention and SGLT2 inhibitor treatment.According to the electronic medical records of the patient's hospital,the clinical staging of the disease was recorded after 6 months of continuous treatment.Based on the staging evaluation results,the patients were divided into progression group(36 cases)and non-progression group(112 cases).The data between these two groups were compared to analyze the influencing factors of disease progression.Results:Among the progression group,the proportion of mean blood glucose fluctuation(MAGE)≥4.5 mmol/L,serum uric acid/creatinine(SUA/Cr)≥4,vascular endothelial growth factor-C(VEGF-C)≥173.87 pg/mL,estimated glomerular filtration rate(eGFR)＜70.59 mL/(min·1.73m2),and I-sphingosine phosphate(SIP)＜274.38 pg/mL were all higher than those of the non-progression group,and the difference was statistically significant(P＜0.05).The MAGE≥4.5 mmol/L,eGFR＜70.59 mL/(min·1.73m2),SUA/Cr≥4,SIP＜274.38 pg/mL,and VEGF-C≥173.87 pg/mL might all be the factors influencing the progress of SGLT2 inhibitor treatment in early diabetes nephropathy patients(P＜0.05).Conclusion:Patients with early diabetes nephropathy still have the risk of disease progression after SGLT2 inhibitor treatment,which might be related to the abnormal levels of MAGE,SUA/Cr,eGFR,serum VEGF-C and serum SIP before treatment.