DAPAGLIFLOZIN’S EFFECT ON SERUM HOMOCYSTEINE IN PATIENTS WITH HYPERTENSION COMPLIACTED WITH INSULIN RESISTANCE

Abstract

Objective: Most patients with hypertension complicate with insulin resistance (IR), which is one of risk factors of hypertension and can increase the level of serum homocysteine (hcy) by affecting hcy metabolic enzyme and insulin. Investigations in recent years have shown that hcy is an independent risk factor of cardiovascular diseases. At present, folic acid is the main drug used to reduce hcy, but its effection for hcy has obvious individual difference, which is closely related to individual genes. Moreover, folic acid (FA) is mostly used in patients with hcy beyond 15 mol/l, but hcy beyond 10 mol/l has had an adverse effect for cardiovascular system. Animal studies have shown that dapagliflozin can improve insulin resistance. Therefore, whether it can reduce hcy has become a new direction. Design and method: This study is a retrospective case-control study. Patients with highly serum hcy and hypertension complicated with insulin resistance are divided into two groups: dapagliflozin group and FA group. Before and after 12 weeks of treatment, the changes in serum hcy and IR index are measured and compared. Results: (1) The IR index and serum hcy levels are clearly lower in the dapagliflozin group after therapy, and the changement of IR index and the level of serum hcy has a significant relativity. (2) The IR index reduction is more noticeable in the dapagliflozin group than in FA group. (3) In dapagliflozin group, the standard deviation (SD) of serum hcy is lower than in the FA group. Conclusions: Dapagliflozin can reduce the serum hcy level of patients with hypertension and insulin resistance in a certain extent, also having an important effection in reducing IR. The lowering of serum hcy in the dapagliflozin group is more balanced than in the FA group. Dapagliflozin could be a viable option for these patients.