Dapagliflozin reduces systemic inflammation in patients with type 2 diabetes without known heart failure.
Cardiovasc Diabetol
; 23(1): 197, 2024 Jun 07.
Article
in En
| MEDLINE
| ID: mdl-38849829
ABSTRACT
OBJECTIVE:
Sodium glucose cotransporter 2 (SGLT2) inhibitors significantly improve cardiovascular outcomes in diabetic patients; however, the mechanism is unclear. We hypothesized that dapagliflozin improves cardiac outcomes via beneficial effects on systemic and cardiac inflammation and cardiac fibrosis. RESEARCH AND DESIGNMETHODS:
This randomized placebo-controlled clinical trial enrolled 62 adult patients (mean age 62, 17% female) with type 2 diabetes (T2D) without known heart failure. Subjects were randomized to 12 months of daily 10 mg dapagliflozin or placebo. For all patients, blood/plasma samples and cardiac magnetic resonance imaging (CMRI) were obtained at time of randomization and at the end of 12 months. Systemic inflammation was assessed by plasma IL-1B, TNFα, IL-6 and ketone levels and PBMC mitochondrial respiration, an emerging marker of sterile inflammation. Global myocardial strain was assessed by feature tracking; cardiac fibrosis was assessed by T1 mapping to calculate extracellular volume fraction (ECV); and cardiac tissue inflammation was assessed by T2 mapping.RESULTS:
Between the baseline and 12-month time point, plasma IL-1B was reduced (- 1.8 pg/mL, P = 0.003) while ketones were increased (0.26 mM, P = 0.0001) in patients randomized to dapagliflozin. PBMC maximal oxygen consumption rate (OCR) decreased over the 12-month period in the placebo group but did not change in patients receiving dapagliflozin (- 158.9 pmole/min/106 cells, P = 0.0497 vs. - 5.2 pmole/min/106 cells, P = 0.41), a finding consistent with an anti-inflammatory effect of SGLT2i. Global myocardial strain, ECV and T2 relaxation time did not change in both study groups. GOV REGISTRATION NCT03782259.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Benzhydryl Compounds
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Biomarkers
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Inflammation Mediators
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Diabetes Mellitus, Type 2
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Sodium-Glucose Transporter 2 Inhibitors
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Glucosides
Language:
En
Journal:
Cardiovasc Diabetol
/
Cardiovasc. diabetol. (Online)
/
Cardiovascular diabetology (Online)
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
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ENDOCRINOLOGIA
Year:
2024
Type:
Article
Affiliation country:
United States