The promising significance of liraglutide combined with dapagliflozin or empagliflozin in the prevention of early diabetic nephropathy.

OBJECTIVE: To explore the significance of liraglutide combined with dapagliflozin or empagliflozin in the prevention of early diabetic nephropathy (DN) and its effects on renal function indices. METHODS: Three hundred patients with type 2 diabetes mellitus (T2DM) treated in our hospital from April 2019 to April 2020 were retrospectively included and divided into two groups according to different treatment regimens. Among them, 150 patients who received liraglutide alone were included in the single-drug group, and 150 patients treated with liraglutide combined with dapagliflozin or empagliflozin were included in the combination group. The baseline data and the improvement of inflammatory indices, blood glucose indices and renal function-related indices were compared between the two groups of patients. RESULTS: The baseline data such as age, body mass index, retinopathy, and course of disease had no significant difference between the two groups ( > 0.05). After treatment, the waist-to-hip ratio, total body fat percentage, total body fat mass, total body lean mass, and A/G ratio were significantly decreased in both groups ( < 0.05) compared with before treatment, and were significantly lower in the combination group than in the single-drug group ( < 0.05). The combination group had significantly lower urinary transferrin (Tf), neutrophil gelatinase-associated lipocalin (NGAL) and tumor necrosis factor (TNF)-α, insulin-like growth factor 1 (IGF-1), retinol-binding protein (RBP), homocysteine (Hcy), brain natriuretic peptide (BNP), 24 h urinary albumin excretion ratio (UAER), urine albumin to creatinine ratio (UACR) and urinary liver-type fatty acid binding protein (L-FABP) levels, and higher secretory frizzled-related protein 5 levels than the single-drug group after treatment ( < 0.05). CONCLUSION: Liraglutide combined with dapagliflozin or empagliflozin treatment can effectively reduce the levels of Tf, NGAL and TNF-α in patients with T2DM, and improve the renal function in terms of IGF-1, RBP, Hcy, BNP, UAER, UACR, L-FABP, showing high treatment safety.