A study on the effects of dapagliflozin combined tripterygium glycosides with on serum oxidative stress status,fibrosis markers,and Klotho protein expression in patients with diabetic nephropathy
Li Ji
Bai Shoujun
Qu Xiaolei
Ji Tingting
Abstract：Objective To assess the clinical impact of dapagliflozin in combination with tripterygium wilfordii glycosides on patients with type 2 diabetic nephropathy,and to investigate its effects on serum Klotho protein levels,fibrosis markers,and oxidative stress indicators.Methods A prospective study was conducted in 116 patients with type 2 diabetic nephropathy in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University,who were randomly divided into a combination group(dagaglizin combined with tripterygium glycoside)and a control group(daglizin alone).The 24-hour albuminuria,Klotho protein and Transforming growth factor beta 1 before and after treatment were compared between the two groups.transforming growth factor beta 1(TGF-β1),connective tissue growth factor(CTGF),superoxide dismutase(SOD),malondialdehyde(MDA)changes of and glutathione peroxidase(GSH-Px),blood glucose,body mass index,liver function and adverse reactions in oxidase.Result Post-treatment,both groups experienced improvements in 24-hour proteinuria,with the combination group showing a more significant degree of improvement(t=11.315,P<0.05).Serum Klotho protein level was increased in both groups,but the increase was greater in the combined treatment group(t=31.981,P<0.05).The fibrosis index TGF-β1,CTGF and oxidative stress index MDA were significantly decreased,and the decrease was more significant in the combined treatment group(t=27.728,14.148,10.609,P<0.05).The levels of antioxidant enzymes SOD and GSH-Px were significantly increased,and the increases were more prominent in the combined treatment group(t=11.587,10.790,P<0.05).Pearson correlation analysis showed that Klotho protein was negatively correlated with 24 h albuminuria,TGF-β1,CTGF and MDA levels before and after treatment(r=-0.365,-0.278,-0.327,-0.419,P<0.05).It was positively correlated with SOD and GSH-Px levels(r=0.256,0.334,P<0.05).After treatment,fasting blood glucose,2 h postmeal blood glucose,body mass index and HBA1c in the combined treatment group were lower than those in the Daglipzin group(t=2.162,19.449,2.215,5.358,P<0.05).After treatment,there was no significant difference between alanine aminotransferase(ALT)and aspartate aminotransferase(AST)groups(t=4.804,5.070,P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ2=0.152,P>0.05).Conclusion The combined treatment of dapagliflozin and tripterygium wilfordii glycosides for Type 2 diabetes nephropathy can significantly reduce proteinuria,delay the deterioration of renal function,and may achieve this through upregulation of Klotho protein,inhibition of renal interstitial fibrosis,and alleviation of oxidative stress.The treatment process is safe and provides an effective and safe therapeutic option for patients with Type 2 diabetes nephropathy.
Keywords：Tripterygium wilfordii polyglycosidesDapagliflozinType 2 diabetes nephropathySerum klotho proteinRenal interstitial fibrosis
Publication Date：2025-02-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 115-119 )