Empagliflozin and Arterial Stiffness in Patients with Type 2 Diabetes: A Real-World Case-Control Study.

Francesco Tassone, Cinzia Ferreri, Arianna Rossi, Giorgio Borretta, Guido Pastorini, Fabio Anastasio, Mauro Feola
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Abstract

Background: Sodium-glucose cotransporter-2 (SGLT2) inhibitors have demonstrated beneficial cardiovascular and renal effects in patients with type 2 diabetes mellitus (T2DM).

Objective: The objective of this case-control study was to evaluate the efficacy of empagliflozin in modifying the arterial stiffness in type 2 diabetic patients.

Methods: Pulse wave velocity (PWV) and other parameters of arterial stiffness were assessed at baseline and after three months of empagliflozin treatment in 16 consecutive outpatients with type 2 diabetes mellitus (T2DM) exhibiting normal left ventricular function and no signs of heart failure. A control group of 16 T2DM outpatients not treated with SGLT2 inhibitors was used for comparison.

Results: Duration of diabetes mellitus and sex distribution did not differ between groups. Patients in the empagliflozin group were younger compared to controls (64.1 ± 8.68 vs 74.45 ± 8.13, p < 0.05). At 3-month follow-up, empagliflozin treatment significantly reduced HbA1c (7.9 ± 0.78 vs 7.04 ± 1.09%, p < 0.008). Empagliflozin significantly improved PWV compared to controls (from 13.2 ± 2.0 m/sec to 12.3 ± 1.8 m/sec; P = 0.001; in the control group 12.8 ± 2.3m/s to 13.2 ± 2.4, p = ns, with age and HbA1c as covariates) as well as body weight that significantly reduced (86.75 ± 16.16 kg vs 81.71 ± 16.5 kg, p =0.001) and BMI (30.48 ± 5.4 versus 28.75 ± 5.66 kg/m2, p < 0.002) in comparison to controls. Estimated glomerular filtration rate (eGFR) remained unchanged whereas a significant improvement of urine Albumin to Creatinine ratio with empagliflozin emerged (17.8 ± 46.8 vs 12.2 ± 35.7 mg/mmol, p = 0.049).

Conclusion: In this clinical study, mid-term treatment with empagliflozin in patients with type 2 diabetes mellitus (T2DM) resulted in a significant reduction in arterial stiffness. Additionally, the improvement in the urine albumin-to-creatinine ratio suggests a potential enhancement in endothelial function.

.

Empagliflozin 与 2 型糖尿病患者的动脉僵化:真实世界病例对照研究》。
背景:钠-葡萄糖共转运体-2(SGLT2)抑制剂对2型糖尿病(T2DM)患者的心血管和肾脏具有有益影响:本病例对照研究旨在评估替格列净(empagliflozin)在改善2型糖尿病患者动脉僵化方面的疗效:连续对16名左心室功能正常、无心力衰竭症状的2型糖尿病(T2DM)门诊患者进行了基线和三个月的恩格列净治疗后的脉搏波速度(PWV)和其他动脉僵化参数评估。16 名未接受 SGLT2 抑制剂治疗的 2 型糖尿病门诊患者作为对照组进行比较:结果:各组患者的糖尿病病程和性别分布没有差异。与对照组相比,empagliflozin组患者更年轻(64.1 ± 8.68 vs 74.45 ± 8.13,P < 0.05)。在3个月的随访中,empagliflozin治疗显著降低了HbA1c(7.9 ± 0.78 vs 7.04 ± 1.09%,p < 0.008)。与对照组相比,恩格列净可明显改善脉搏波速度(从 13.2 ± 2.0 米/秒降至 12.3 ± 1.8 米/秒;P = 0.001;对照组从 12.8 ± 2.3 米/秒降至 13.2 ± 2.4,P = ns,以年龄和 HbA1c 为协变量)以及体重(86.75 ± 16.16 千克对 81.71 ± 16.5 千克,P =0.001)和体重指数(30.48 ± 5.4 对 28.75 ± 5.66 千克/平方米,P < 0.002)与对照组相比显著降低。估计肾小球滤过率(eGFR)保持不变,而使用empagliflozin后,尿液白蛋白与肌酐比值显著改善(17.8 ± 46.8 vs 12.2 ± 35.7 mg/mmol,p = 0.049):在这项临床研究中,对2型糖尿病(T2DM)患者使用empagliflozin进行中期治疗可显著降低动脉僵化。此外,尿白蛋白与肌酐比值的改善也表明内皮功能可能会增强。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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