Metabolic Effects of Empagliflozin in Patients with Type 2 Diabetes Mellitus and Obesity
https://doi.org/10.31550/1727-2378-2023-22-4-47-52
Abstract
Aim: to study metabolic effects of empaglilozin in patients with type 2 diabetes and obesity.
Design. Single center prospective randomized study.
Materials and Methods. The study included 46 patients (10 men and 36 women) aged 37–69 years with previously diagnosed T2D and obesity. Patients were randomized into two groups by random numbers: in the main group (n = 22), empagliflozin 25 mg/day was added to metformin 2000 mg/day, the control group (n = 24) continued therapy with metformin 2000 mg/day. We looked such indicators, as anthropometric data were assessed: body weight (BW), waist circumference (WC), body mass index (BMI), glycemic control, and metabolic health markers (adiponectin, leptin) at baseline and after 6 months of therapy.
Results. Although we didn’t find pronounced glycemic effect in the combined treatment group, but we showed positive dynamics of anthropometric parameters — a decrease in BW (p = 0.035), WC (p = 0.04), BMI (p = 0.005) — we found a decrease in leptin levels from 28.8 ± 11.0 to 21.0 ± 9.13 ng/ml (p = 0.035). In the main group, the level of adiponectin increased statistically significantly (p = 0.002) from 9.70 ± 2.15 to 13.0 ± 3.18 μg/ml.
Conclusion. Significant non-glycemic effects of empagliflozin were obtained.
About the Authors
A. P. Misharova
Russian Medical Academy of Continuous Professional Education; National Research Center for Preventive Medicine
Russian Federation
Russian Federation
2/1 Barrikadnaya Str., build. 1, Moscow, 25993 ; 10 Petroverigsky per., build. 3, Moscow, 101990
L. V. Kondratieva
Russian Medical Academy of Continuous Professional Education
Russian Federation
Russian Federation
2/1 Barrikadnaya Str., build. 1, Moscow, 25993
T. N. Korotkova
Federal Research Centre of Nutrition, Biotechnology and Food Safety
Russian Federation
Russian Federation
2/14 Ust’insky proezd, build. 1, Moscow, 109240
References
1. Oldridge N.B., Stump T.E., Nothwehr F.K., Clark D.O. Prevalence and outcomes of comorbid metabolic and cardiovascular conditions in middle- and older-age adults. J. Clin. Epidemiol. 2001; 54(9):928– 934. doi: 10.1016/s0895-4356(01)00350-x
2. Drapkina O.M., Samorodskaya I.V., Starinskaya M.A. et al. Obesity: evaluation and management of patients. Moscow; 2021. (in Russian). 174 p.
3. The interim experts’ counsil resolution on the EMPA-REG OUTCOME trial issues. Diabetes Mellitus. 2016;19(2):182–185. (in Russian). DOI: 10.14341/ DM2004156-61
4. Neal B., Perkovic V., Mahaffey K.W. et al.; CANVAS Programme Collaborative Group. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N. Engl. J. Med. 2017;377(7):644–657. DOI: https://doi.org/10.1056/NEJMoa1611925
5. Shestakova M.V., Ametov A.S., Anciferov M.B. et al. Canagliflozin: from glycemic control to improvement of cardiovascular and renal prognosis in patients with type 2 diabetes mellitus. Resolution of Advisory Board. Diabetes Mellitus. 2021;24(5):479–486. (in Russian). DOI: https://doi.org/10.14341/DM12848
6. Shestakova M.V. DECLARE-TIMI 58 trial in the context of EMPAREG OUTCOME AND CANVAS. Diabetes Mellitus. 2019;22(6):592–601. (in Russian). DOI: 10.14341/DM10289
7. Wiviott S.D., Raz I., Bonaca M.P. et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med. 2019;380(4):347–357. DOI: 10.1056/NEJMoa1812389
8. Furtado R.H., Bonaca M.P., Raz I. et al. Dapagliflozin and cardiovascular outcomes in patients with type 2 diabetes mellitus and previous myocardial infarction. Circulation. 2019;139:2516– 2527. DOI: 10.1161/CIRCULATIONAHA.119.039996
9. Ametov A.S., Pashkova E.Yu., Sharafetdinov A.S., Zhigareva A.V. The role and place of sodium-glucose cotransporter-2 inhibitors in multifactorial management of type 2 diabetes mellitus. Endocrinology: News, Opinions, Training. 2019;8(1):8–16. (in Russian). DOI: 10.24411/2304-9529-2019-11001
10. Zinman B., Wanner C., Lachin J.M. et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N. Engl. J. Med. 2015;373(22):2117–2128. DOI: 10.1056/NEJMoa1504720
11. Tahrani A.A., Barnett A.H., Bailey C.J. SGLT inhibitors in management of diabetes. Lancet Diabetes Endocrinol. 2013;1(2):140–151. DOI: 10.1016/S2213-8587(13)70050-0
12. Saluhov V.V., Demidova T.Yu. Empagliflozin as a new management strategy on outcomes in patients with type 2 diabetes mellitus. Diabetes Mellitus. 2016;19(6):494– 510. (in Russian). DOI 10.14341/DM8216
13. Ridderstråle M., Andersen K.R., Zeller C. et al. Comparison of empagliflozin and glimepiride as add-on to metformin in patients with type 2 diabetes: a 104-week randomised, activecontrolled, double-blind, phase 3 trial. Lancet Diabetes Endocrinol. 2014;2(9):691–700. DOI: 10.1016/S2213-8587(14)70120-2
14. Kotova M.E., Maksim O.V. Saluhov V.V. et al. Effect of the sodium-glucose cotransporter-2 inhibitor empagliflosin on certain clinical-laboratory parameters of the cardiovascular system in patients with type 2 diabetes mellitus and high cardiovascular risk. Medline.Ru. 2018;19:636–662. (in Russian)
15. Cheng X., Folco E.J., Shimizu K., Libby P. Adiponectin induces proinflammatory programs in human macrophages and CD4+ T cells. J. Biol. Chem. 2012;287(44):36896–36904. DOI: 10.1074/ jbc. M112.409516
16. Furuhashi M., Ura N., Moniwa N. et al. Possible impairment of transcardiac utilization of adiponectin in patients with type 2 diabetes. Diabetes Care. 2004;27(9):2217–2221. DOI: 10.2337/ diacare.27.9.2217
17. Kovacova Z., Tencerova M., Roussel B. et al. The impact of obesity on secretion of adiponectin multimeric iso-forms differs in visceral and subcutaneous adipose tissue. Int. J. Obes. (Lond). 2012;36(10):1360–1365. DOI: 10.1038/ijo.2011.223
18. AL-Hamodi Z., AL-Habori M., AL-Meeri A., Saif-ALi R. Association of adipokines, Leptin/adiponectin ratio and C-reactive protein with obesity and type 2 diabetes mellitus. Diabetol Metab. Syndr. 2014;6(1):99. DOI: 10.1186/1758-5996-6-99
19. Lavrenova E.A., Drapkina O.M. Insulin resistance in obesity: pathogenesis and effects. Obesity and metabolism. 2020;17(1):48–55. (in Russian). DOI: 10.14341/omet9759
20. Markova T.N., Mishchenko N.K., Petina D.V. Adipocytokines: modern definition, classification and physiological role. Problems of Endocrinology. 2022;68(1):73–80. (in Russian). DOI: 10.14341/probl12805
Review
For citations:
Misharova A.P., Kondratieva L.V., Korotkova T.N. Metabolic Effects of Empagliflozin in Patients with Type 2 Diabetes Mellitus and Obesity. Title. 2023;22(4):47-52. (In Russ.) https://doi.org/10.31550/1727-2378-2023-22-4-47-52
Views:
14
Email this article 