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TİP 2 DİABETES MELLİTUSU OLAN YENİ TANI HİPERTANSİF HASTALARDA SODYUM GLUKOZ KO-TRANSPORTER 2 İNHİBİTÖRLERİNİN LİPİD DÜZEYLERİ ÜZERİNE ETKİSİ

Year 2023, Volume: 4 Issue: 1, 73 - 79, 29.03.2023

Abstract

Giriş: Bu çalışma, tip 2 diabetes mellitus (T2DM) olan yeni tanı konmuş hipertansif (YTHT) hastalarında 12 haftalık takipte sodyum glukoz kotransporter 2 inhibitörlerinin (SGLT-2i) lipid düzeyleri
üzerindeki etkilerini incelemeyi amaçladı.
Yöntemler: Bu retrospektif çalışmaya, T2DM olan 236 YTHT hastası dahil edildi. SGLT-2i grubu, stabil üçlü kombinasyon tedavisine ek olarak SGLT-2i (empagliflozin veya dapagliflozin) alan hastalardan oluştu. Kontrol grubu, SGLT-2i almayan ve başlangıç risk faktörleri açısından SGLT-2i grubu ile eşleşen T2DM'li YTHT hastaları üzerinden propensity skoru ile seçildi. Hastaların laboratuvar bulguları, YTHT tanısı anında (başlangıç) ve 12 aylık takipte retrospektif olarak karşılaştırıldı.
Bulgular: Açlık kan şekeri ve hemoglobin A1C düzeylerindeki düşüş SGLT-2i grubunda kontrol grubuna göre daha yüksekti. Her iki grup da benzer antihipertansif tedavi almasına rağmen, lipid
profilindeki iyileşme SGLT-2i grubunda daha yüksekti. Empagliflozin ve dapagliflozin gruplarında glisemik kontrol ve yan etkiler benzerdi. Ancak, dapagliflozin kullananlarda lipit profillerinde daha fazla iyileşme saptandı.
Sonuç: T2DM'li YTHT hastalarında, glisemik kontrolün sağlanamadığı durumlarda tedavi yönetimine SGLT-2i eklenmesi, önemli yan etkiler olmaksızın lipid profilinde daha fazla iyileşme ile ilişkilidir. Ancak çeşitli SGLT-2i ajanlarının bu iyileşme üzerindeki etkileri farklı olabilir.

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References

  • 1. Long AN, Dagogo-Jack S. Comorbidities of diabetes and hypertension: mechanisms and approach to target organ protection. J Clin Hypertens (Greenwich) 2011;13:244-51.
  • 2. Chen G, McAlister FA, Walker RL, Hemmelgarn BR, Campbell NR. Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure. Hypertension 2011;57:891-7.
  • 3. Baruah MP, Makkar BM, Ghatnatti VB, Mandal K. Sodium Glucose Co-transporter-2 Inhibitor: Benefits beyond Glycemic Control. Indian J Endocrinol Metab 2019;23:140-49.
  • 4. Tentolouris A, Vlachakis P, Tzeravini E, Eleftheriadou I, Tentolouris N. SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects. Int J Environ Res Public Health 2019;16.
  • 5. Rubattu S, Pagliaro B, Pierelli G, et al. Pathogenesis of target organ damage in hypertension: role of mitochondrial oxidative stress. Int J Mol Sci 2014;16:823- 39.
  • 6. Pownall HJ, Gotto AM, Jr. Lipids and Cardiovascular Disease: Putting It All Together. Methodist Debakey Cardiovasc J 2019;15:5-8.
  • 7. Szekeres Z, Toth K, Szabados E. The Effects of SGLT2 Inhibitors on Lipid Metabolism. Metabolites 2021;11:87.
  • 8. Ptaszynska A, Hardy E, Johnsson E, Parikh S, List J. Effects of dapagliflozin on cardiovascular risk factors. Postgrad Med 2013;125:181-89.
  • 9. Rodriguez-Gutierrez R, Gonzalez-Saldivar G. Canagliflozin. Cleve Clin J Med 2014;81:87-8.
  • 10. Cha SA, Park YM, Yun JS, et al. A comparison of effects of DPP-4 inhibitor and SGLT2 inhibitor on lipid profile in patients with type 2 diabetes. Lipids Health Dis 2017;16:58.
  • 11. Aragon-Herrera A, Feijoo-Bandin S, Otero Santiago M, et al. Empagliflozin reduces the levels of CD36 and cardiotoxic lipids while improving autophagy in the hearts of Zucker diabetic fatty rats. Biochem Pharmacol 2019;170:113677.
  • 12. Rasul S, Geist BK, Brath H, et al. Response evaluation of SGLT2 inhibitor therapy in patients with type 2 diabetes mellitus using (18)F-FDG PET/MRI. BMJ Open Diabetes Res Care 2020;8.
  • 13. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502.
  • 14. Hurst C, Thinkhamrop B, Tran HT. The Association between Hypertension Comorbidity and Microvascular Complications in Type 2 Diabetes Patients: A Nationwide Cross-Sectional Study in Thailand. Diabetes Metab J 2015;39:395-404.
  • 15. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-80.
  • 16. Sonmez A, Haymana C, Bayram F, et al. Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study). Diabetes Res Clin Pract 2018;146:138-47.
  • 17. Ali W, Bakris GL. How to Manage Hypertension in People With Diabetes. Am J Hypertens 2020;33:935-43.
  • 18. Davies MJ, D'Alessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018;61:2461-98.
  • 19. Alguwaihes AM. Safety of Dapagliflozin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia: A Post Authorization Safety Study. Diabetes Ther 2021;12:1979-92.
  • 20. Uitrakul S, Aksonnam K, Srivichai P, Wicheannarat S, Incomenoy S. The Incidence and Risk Factors of Urinary Tract Infection in Patients with Type 2 Diabetes Mellitus Using SGLT2 Inhibitors: A Real-World Observational Study. Medicines (Basel) 2022;9.
  • 21. Ceriello A, Lucisano G, Prattichizzo F, et al. HbA1c variability predicts cardiovascular complications in type 2 diabetes regardless of being at glycemic target. Cardiovascular Diabetology 2022;21:13.
  • 22. Ku EJ, Lee DH, Jeon HJ, Oh TK. Empagliflozin versus dapagliflozin in patients with type2 diabetes inadequately controlled with metformin, glimepiride and dipeptidyl peptide 4 inhibitors: A 52-week prospective observational study. Diabetes Res Clin Pract 2019;151:65-73.
  • 23. Hussain M, Elahi A, Iqbal J, et al. Comparison of Efficacy and Safety Profile of SodiumGlucose Cotransporter-2 Inhibitors as Add-On Therapy in Patients With Type 2 Diabetes. Cureus 2021;13:e14268.
  • 24. Khan S, Hashmi MS, Rana MA, et al. Frequency of Urinary Tract Infections in Type 2 Diabetic Patients Taking Dapagliflozin. Cureus 2022;14:e21720.
  • 25. Li D, Wang T, Shen S, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab 2017;19:348-55.
  • 26. Soppert J, Lehrke M, Marx N, Jankowski J, Noels H. Lipoproteins and lipids in cardiovascular disease: from mechanistic insights to therapeutic targeting. Adv Drug Deliv Rev 2020;159:4-33.
  • 27. Matthaei S, Bowering K, Rohwedder K, et al. Durability and tolerability of dapagliflozin over 52 weeks as add-on to metformin and sulphonylurea in type 2 diabetes. Diabetes Obes Metab 2015;17:1075-84.
  • 28. Monami M, Nardini C, Mannucci E. Efficacy and safety of sodium glucose co-transport-2 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 2014;16:457-66.
  • 29. Nishida Y, Takahashi Y, Nakayama T, Soma M, Asai S. Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study. Cardiovasc Diabetol 2011;10:74.
  • 30. Yu Y, Xue BJ, Wei SG, et al. Activation of central PPAR-gamma attenuates angiotensin II-induced hypertension. Hypertension 2015;66:403-11.
  • 31. Bao Y, Bing C, Hunter L, et al. Zincalpha2-glycoprotein, a lipid mobilizing factor, is expressed and secreted by human (SGBS) adipocytes. FEBS Lett 2005;579:41-7.
  • 32. Liao X, Wang X, Li H, et al. SodiumGlucose Cotransporter 2 (SGLT2) Inhibitor Increases Circulating Zinc-Alpha2-Glycoprotein Levels in Patients with Type 2 Diabetes. Sci Rep 2016;6:32887.
  • 33. Cianciolo G, De Pascalis A, Capelli I, et al. Mineral and Electrolyte Disorders With SGLT2i Therapy. JBMR Plus 2019;3:e10242.
  • 34. Chun S, Bamba T, Suyama T, et al. A High Phosphorus Diet Affects Lipid Metabolism in Rat Liver: A DNA Microarray Analysis. PLoS One 2016;11:e0155386.
  • 35. Aragon-Herrera A, Otero-Santiago M, Anido-Varela L, et al. The Treatment With the SGLT2 Inhibitor Empagliflozin Modifies the Hepatic Metabolome of Male Zucker Diabetic Fatty Rats Towards a Protective Profile. Front Pharmacol 2022;13:827033.
  • 36. Sun K, Su T, Li M, et al. Serum potassium level is associated with metabolic syndrome: a populationbased study. Clin Nutr 2014;33:521-7.
  • 37. Alomaim H, Griffin P, Swist E, et al. Dietary calcium affects body composition and lipid metabolism in rats. PLoS One 2019;14:e0210760.
  • 38. Briand F, Mayoux E, Brousseau E, et al. Empagliflozin, via Switching Metabolism Toward Lipid Utilization, Moderately Increases LDL Cholesterol Levels Through Reduced LDL Catabolism. Diabetes 2016;65:2032- 8.
  • 39. Heald AH, Fryer AA, Anderson SG, et al. Sodium-glucose co-transporter-2 inhibitors, the latest residents on the block: Impact on glycaemic control at a general practice level in England. Diabetes Obes Metab 2018;20:1659-69.
  • 40. Anker SD, Butler J. Empagliflozin, calcium, and SGLT1/2 receptor affinity: another piece of the puzzle. ESC Heart Fail 2018;5:549-51.
  • 41. Shao SC, Chang KC, Hung MJ, et al. Comparative risk evaluation for cardiovascular events associated with dapagliflozin vs. empagliflozin in real-world type 2 diabetes patients: a multi-institutional cohort study. Cardiovasc Diabetol 2019;18:120

EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS

Year 2023, Volume: 4 Issue: 1, 73 - 79, 29.03.2023

Abstract

Aim: This study aimed to examine the effects of sodium glucose cotransporter 2 inhibitors (SGLT-2i) on lipid levels at 12 weeks of follow-up in newly diagnosed hypertensive (NDHT) patients with type 2 diabetes mellitus (T2DM).
Methodsː This retrospective study, 236 NDHT patients with T2DM were included. The SGLT-2i group consisted of patients who received SGLT-2i (empagliflozin or dapagliflozin) in addition to stable triple combination treatment. The control group was selected over NDHT patients with T2DM who did not receive SGLT-2i and matched with the SGLT-2i group in terms of baseline risk factors by propensity score. The laboratory findings of the patients were compared retrospectively at the time of diagnosis of NDHT (baseline) and at 12-month followup.
Resultsː The decrease in fasting blood glucose and hemoglobin A1C levels was higher in the SGLT-2i group than control group. Although both groups received similar antihypertensive therapy, the
improvement in lipid profile was higher in the SGLT-2i group. Glycemic control and side effects were similar in empagliflozin and dapagliflozin groups. However, greater improvement in lipid profiles was detected in dapagliflozin users.
Conclusionsː In NDHT patients with T2DM, the addition of SGLT2i to treatment management in cases where glycemic control is not achieved is associated with more improvement of the lipid profile without significant side effects. However, the effects of various SGLT2i agents on this improvement may be different.

References

  • 1. Long AN, Dagogo-Jack S. Comorbidities of diabetes and hypertension: mechanisms and approach to target organ protection. J Clin Hypertens (Greenwich) 2011;13:244-51.
  • 2. Chen G, McAlister FA, Walker RL, Hemmelgarn BR, Campbell NR. Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure. Hypertension 2011;57:891-7.
  • 3. Baruah MP, Makkar BM, Ghatnatti VB, Mandal K. Sodium Glucose Co-transporter-2 Inhibitor: Benefits beyond Glycemic Control. Indian J Endocrinol Metab 2019;23:140-49.
  • 4. Tentolouris A, Vlachakis P, Tzeravini E, Eleftheriadou I, Tentolouris N. SGLT2 Inhibitors: A Review of Their Antidiabetic and Cardioprotective Effects. Int J Environ Res Public Health 2019;16.
  • 5. Rubattu S, Pagliaro B, Pierelli G, et al. Pathogenesis of target organ damage in hypertension: role of mitochondrial oxidative stress. Int J Mol Sci 2014;16:823- 39.
  • 6. Pownall HJ, Gotto AM, Jr. Lipids and Cardiovascular Disease: Putting It All Together. Methodist Debakey Cardiovasc J 2019;15:5-8.
  • 7. Szekeres Z, Toth K, Szabados E. The Effects of SGLT2 Inhibitors on Lipid Metabolism. Metabolites 2021;11:87.
  • 8. Ptaszynska A, Hardy E, Johnsson E, Parikh S, List J. Effects of dapagliflozin on cardiovascular risk factors. Postgrad Med 2013;125:181-89.
  • 9. Rodriguez-Gutierrez R, Gonzalez-Saldivar G. Canagliflozin. Cleve Clin J Med 2014;81:87-8.
  • 10. Cha SA, Park YM, Yun JS, et al. A comparison of effects of DPP-4 inhibitor and SGLT2 inhibitor on lipid profile in patients with type 2 diabetes. Lipids Health Dis 2017;16:58.
  • 11. Aragon-Herrera A, Feijoo-Bandin S, Otero Santiago M, et al. Empagliflozin reduces the levels of CD36 and cardiotoxic lipids while improving autophagy in the hearts of Zucker diabetic fatty rats. Biochem Pharmacol 2019;170:113677.
  • 12. Rasul S, Geist BK, Brath H, et al. Response evaluation of SGLT2 inhibitor therapy in patients with type 2 diabetes mellitus using (18)F-FDG PET/MRI. BMJ Open Diabetes Res Care 2020;8.
  • 13. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18:499-502.
  • 14. Hurst C, Thinkhamrop B, Tran HT. The Association between Hypertension Comorbidity and Microvascular Complications in Type 2 Diabetes Patients: A Nationwide Cross-Sectional Study in Thailand. Diabetes Metab J 2015;39:395-404.
  • 15. Satman I, Omer B, Tutuncu Y, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28:169-80.
  • 16. Sonmez A, Haymana C, Bayram F, et al. Turkish nationwide survEy of glycemic and other Metabolic parameters of patients with Diabetes mellitus (TEMD study). Diabetes Res Clin Pract 2018;146:138-47.
  • 17. Ali W, Bakris GL. How to Manage Hypertension in People With Diabetes. Am J Hypertens 2020;33:935-43.
  • 18. Davies MJ, D'Alessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018;61:2461-98.
  • 19. Alguwaihes AM. Safety of Dapagliflozin in Patients with Type 2 Diabetes Mellitus in Saudi Arabia: A Post Authorization Safety Study. Diabetes Ther 2021;12:1979-92.
  • 20. Uitrakul S, Aksonnam K, Srivichai P, Wicheannarat S, Incomenoy S. The Incidence and Risk Factors of Urinary Tract Infection in Patients with Type 2 Diabetes Mellitus Using SGLT2 Inhibitors: A Real-World Observational Study. Medicines (Basel) 2022;9.
  • 21. Ceriello A, Lucisano G, Prattichizzo F, et al. HbA1c variability predicts cardiovascular complications in type 2 diabetes regardless of being at glycemic target. Cardiovascular Diabetology 2022;21:13.
  • 22. Ku EJ, Lee DH, Jeon HJ, Oh TK. Empagliflozin versus dapagliflozin in patients with type2 diabetes inadequately controlled with metformin, glimepiride and dipeptidyl peptide 4 inhibitors: A 52-week prospective observational study. Diabetes Res Clin Pract 2019;151:65-73.
  • 23. Hussain M, Elahi A, Iqbal J, et al. Comparison of Efficacy and Safety Profile of SodiumGlucose Cotransporter-2 Inhibitors as Add-On Therapy in Patients With Type 2 Diabetes. Cureus 2021;13:e14268.
  • 24. Khan S, Hashmi MS, Rana MA, et al. Frequency of Urinary Tract Infections in Type 2 Diabetic Patients Taking Dapagliflozin. Cureus 2022;14:e21720.
  • 25. Li D, Wang T, Shen S, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab 2017;19:348-55.
  • 26. Soppert J, Lehrke M, Marx N, Jankowski J, Noels H. Lipoproteins and lipids in cardiovascular disease: from mechanistic insights to therapeutic targeting. Adv Drug Deliv Rev 2020;159:4-33.
  • 27. Matthaei S, Bowering K, Rohwedder K, et al. Durability and tolerability of dapagliflozin over 52 weeks as add-on to metformin and sulphonylurea in type 2 diabetes. Diabetes Obes Metab 2015;17:1075-84.
  • 28. Monami M, Nardini C, Mannucci E. Efficacy and safety of sodium glucose co-transport-2 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 2014;16:457-66.
  • 29. Nishida Y, Takahashi Y, Nakayama T, Soma M, Asai S. Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study. Cardiovasc Diabetol 2011;10:74.
  • 30. Yu Y, Xue BJ, Wei SG, et al. Activation of central PPAR-gamma attenuates angiotensin II-induced hypertension. Hypertension 2015;66:403-11.
  • 31. Bao Y, Bing C, Hunter L, et al. Zincalpha2-glycoprotein, a lipid mobilizing factor, is expressed and secreted by human (SGBS) adipocytes. FEBS Lett 2005;579:41-7.
  • 32. Liao X, Wang X, Li H, et al. SodiumGlucose Cotransporter 2 (SGLT2) Inhibitor Increases Circulating Zinc-Alpha2-Glycoprotein Levels in Patients with Type 2 Diabetes. Sci Rep 2016;6:32887.
  • 33. Cianciolo G, De Pascalis A, Capelli I, et al. Mineral and Electrolyte Disorders With SGLT2i Therapy. JBMR Plus 2019;3:e10242.
  • 34. Chun S, Bamba T, Suyama T, et al. A High Phosphorus Diet Affects Lipid Metabolism in Rat Liver: A DNA Microarray Analysis. PLoS One 2016;11:e0155386.
  • 35. Aragon-Herrera A, Otero-Santiago M, Anido-Varela L, et al. The Treatment With the SGLT2 Inhibitor Empagliflozin Modifies the Hepatic Metabolome of Male Zucker Diabetic Fatty Rats Towards a Protective Profile. Front Pharmacol 2022;13:827033.
  • 36. Sun K, Su T, Li M, et al. Serum potassium level is associated with metabolic syndrome: a populationbased study. Clin Nutr 2014;33:521-7.
  • 37. Alomaim H, Griffin P, Swist E, et al. Dietary calcium affects body composition and lipid metabolism in rats. PLoS One 2019;14:e0210760.
  • 38. Briand F, Mayoux E, Brousseau E, et al. Empagliflozin, via Switching Metabolism Toward Lipid Utilization, Moderately Increases LDL Cholesterol Levels Through Reduced LDL Catabolism. Diabetes 2016;65:2032- 8.
  • 39. Heald AH, Fryer AA, Anderson SG, et al. Sodium-glucose co-transporter-2 inhibitors, the latest residents on the block: Impact on glycaemic control at a general practice level in England. Diabetes Obes Metab 2018;20:1659-69.
  • 40. Anker SD, Butler J. Empagliflozin, calcium, and SGLT1/2 receptor affinity: another piece of the puzzle. ESC Heart Fail 2018;5:549-51.
  • 41. Shao SC, Chang KC, Hung MJ, et al. Comparative risk evaluation for cardiovascular events associated with dapagliflozin vs. empagliflozin in real-world type 2 diabetes patients: a multi-institutional cohort study. Cardiovasc Diabetol 2019;18:120
There are 41 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Birsen Doğanay 0000-0003-4659-3596

Ozlem Ozcan Celebi 0000-0003-1527-6440

Publication Date March 29, 2023
Published in Issue Year 2023 Volume: 4 Issue: 1

Cite

APA Doğanay, B., & Ozcan Celebi, O. (2023). EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eskisehir Medical Journal, 4(1), 73-79.
AMA Doğanay B, Ozcan Celebi O. EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eskisehir Med J. March 2023;4(1):73-79.
Chicago Doğanay, Birsen, and Ozlem Ozcan Celebi. “EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS”. Eskisehir Medical Journal 4, no. 1 (March 2023): 73-79.
EndNote Doğanay B, Ozcan Celebi O (March 1, 2023) EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eskisehir Medical Journal 4 1 73–79.
IEEE B. Doğanay and O. Ozcan Celebi, “EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS”, Eskisehir Med J, vol. 4, no. 1, pp. 73–79, 2023.
ISNAD Doğanay, Birsen - Ozcan Celebi, Ozlem. “EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS”. Eskisehir Medical Journal 4/1 (March 2023), 73-79.
JAMA Doğanay B, Ozcan Celebi O. EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eskisehir Med J. 2023;4:73–79.
MLA Doğanay, Birsen and Ozlem Ozcan Celebi. “EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS”. Eskisehir Medical Journal, vol. 4, no. 1, 2023, pp. 73-79.
Vancouver Doğanay B, Ozcan Celebi O. EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS. Eskisehir Med J. 2023;4(1):73-9.