A prospective randomized study comparing effects of empagliflozin to sitagliptin on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes: the ASSET study.
Adiposity
/ drug effects
Adult
Benzhydryl Compounds
/ adverse effects
Biomarkers
/ blood
Blood Glucose
/ drug effects
Cardiovascular Diseases
/ diagnosis
Diabetes Mellitus, Type 2
/ diagnosis
Dipeptidyl-Peptidase IV Inhibitors
/ adverse effects
Energy Metabolism
/ drug effects
Female
Glucosides
/ adverse effects
Glycated Hemoglobin
/ metabolism
Heart
/ drug effects
Humans
Male
Middle Aged
Myocardium
/ metabolism
Primary Prevention
Prospective Studies
Sitagliptin Phosphate
/ adverse effects
Sodium-Glucose Transporter 2 Inhibitors
/ adverse effects
Time Factors
Tokyo
Treatment Outcome
123I-BMIPP scintigraphy
DPP-4 inhibitor
Early-stage type 2 diabetes mellitus
Epicardial fat
Myocardial triglyceride content
Pericardial fat
Preserved cardiac function
SGLT2 inhibitor
Journal
Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637
Informations de publication
Date de publication:
02 02 2021
02 02 2021
Historique:
received:
09
12
2020
accepted:
25
01
2021
entrez:
3
2
2021
pubmed:
4
2
2021
medline:
6
10
2021
Statut:
epublish
Résumé
While the cardioprotective benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors have been established in patients with cardiovascular disease (CVD), their advantages over other anti-diabetic drugs at earlier stages remain unclear. We compared the cardioprotective effects of empagliflozin, an SGLT2 inhibitor, with those of sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, focusing on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes mellitus (T2DM) without CVD complications. This was a prospective, randomized, open-label, blinded-endpoint, parallel-group trial that enrolled 44 Japanese patients with T2DM. The patients were randomized for 12-week administration of empagliflozin or sitagliptin. Pericardial fat accumulation and myocardial triglyceride content were evaluated by magnetic resonance imaging and proton magnetic resonance spectroscopy, respectively. Echocardiography, The patients were middle-aged (50.3 ± 10.7 years, mean ± standard deviation) and overweight (body mass index 29.3 ± 4.9 kg/m Although the effects on cardiac fat and function were not statistically different between the two groups, empagliflozin exhibited superior effects on cardiometabolic biomarkers, such as uric acid, high-density lipoprotein cholesterol, ketone bodies, and insulin sensitivity. Therefore, when considering the primary preventive strategies for CVD, early supplementation with SGLT2 inhibitors may be more beneficial than DPP-4 inhibitors, even in patients with early-stage T2DM without current CVD complications. UMIN000026340; registered on February 28, 2017. https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000030257.
Sections du résumé
BACKGROUND
While the cardioprotective benefits of sodium-glucose cotransporter-2 (SGLT2) inhibitors have been established in patients with cardiovascular disease (CVD), their advantages over other anti-diabetic drugs at earlier stages remain unclear. We compared the cardioprotective effects of empagliflozin, an SGLT2 inhibitor, with those of sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, focusing on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes mellitus (T2DM) without CVD complications.
METHODS
This was a prospective, randomized, open-label, blinded-endpoint, parallel-group trial that enrolled 44 Japanese patients with T2DM. The patients were randomized for 12-week administration of empagliflozin or sitagliptin. Pericardial fat accumulation and myocardial triglyceride content were evaluated by magnetic resonance imaging and proton magnetic resonance spectroscopy, respectively. Echocardiography,
RESULTS
The patients were middle-aged (50.3 ± 10.7 years, mean ± standard deviation) and overweight (body mass index 29.3 ± 4.9 kg/m
CONCLUSIONS
Although the effects on cardiac fat and function were not statistically different between the two groups, empagliflozin exhibited superior effects on cardiometabolic biomarkers, such as uric acid, high-density lipoprotein cholesterol, ketone bodies, and insulin sensitivity. Therefore, when considering the primary preventive strategies for CVD, early supplementation with SGLT2 inhibitors may be more beneficial than DPP-4 inhibitors, even in patients with early-stage T2DM without current CVD complications.
CLINICAL TRIAL REGISTRATION
UMIN000026340; registered on February 28, 2017. https://upload.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000030257.
Identifiants
pubmed: 33530982
doi: 10.1186/s12933-021-01228-3
pii: 10.1186/s12933-021-01228-3
pmc: PMC7852076
doi:
Substances chimiques
Benzhydryl Compounds
0
Biomarkers
0
Blood Glucose
0
Dipeptidyl-Peptidase IV Inhibitors
0
Glucosides
0
Glycated Hemoglobin A
0
Sodium-Glucose Transporter 2 Inhibitors
0
hemoglobin A1c protein, human
0
empagliflozin
HDC1R2M35U
Sitagliptin Phosphate
TS63EW8X6F
Banques de données
UMIN-CTR
['UMIN000026340']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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