Abstract
OBJECTIVE: This study explores the effect of dapagliflozin treatment on podocyte injury and oxidative stress in patients with early diabetic nephropathy (T2DN). Methods: Clinical data from 78 patients with early T2DN, admitted to our hospital between June 2021 and June 2023, were collected and analyzed. METHODS: This study was a single-center, prospective randomized controlled trial. Clinical data from 78 patients with early T2DN admitted to our hospital between June 2021 and June 2023 were collected and analyzed. The 78 patients were divided into two groups: observation and control, with 39 receiving different treatments. Patients in the control group received sitagliptin phosphate tablets, while patients in the observation group received dapagliflozin tablets. The total efficacy of therapy and the frequency of adverse reactions were compared between the observation and control groups. Serum concentrations of malondialdehyde (MDA), reactive oxygen species (ROS), superoxide dismutase (SOD), podocyte marker protein (PCX), podocyte slit diaphragm protein (Nephrin), gelatinase-associated apolipoprotein (NGAI), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) were analyzed in both groups. RESULTS: The total effective rate of treatment in the observation group was significantly higher than in the control group (89.74% vs. 66.67%, P < 0.05). Both groups showed significant decreases in serum MDA and ROS levels and increases in SOD levels after treatment (P < 0.05). However, the observation group exhibited a greater reduction in oxidative stress markers compared to the control group (P < 0.05). Podocyte damage indicators (PCX and Nephrin) increased significantly in both groups, while NGAI levels decreased after treatment. The observation group demonstrated more significant improvements in podocyte markers compared to the control group (P < 0.05). FBG and HbA1c levels decreased significantly in both groups after treatment, with the observation group showing a more substantial reduction (P < 0.05). The incidence of adverse reactions was higher in the observation group (23.08%) compared to the control group (10.26%), but this difference was not statistically significant (P > 0.05). CONCLUSION: Dapagliflozin has a good safety profile, demonstrating superior efficacy in reducing oxidative stress and podocyte injury in patients with early-stage T2DN. It can effectively lower blood glucose and has promising clinical applications in managing diabetic nephropathy.