Effects of Dapagliflozin on Serum Low-Density Lipoprotein Cholesterol and Triglyceride Levels

Eren Gürkan

doi:10.5152/eurjther.2020.19005

Authors

Eren Gürkan Department of Endocrinology and Metabolism, Mustafa Kemal University School of Medicine, Hatay, Turkey https://orcid.org/0000-0002-3118-4549

DOI:

https://doi.org/10.5152/eurjther.2020.19005

Keywords:

Cardiovascular diseases, dapagliflozin, hyperlipidemia, SGLT2 inhibitor

Abstract

Objective: The aim of this study is to assess the effects of dapagliflozin, a sodium/glucose cotransporter 2 (SGLT2) inhibitor, on serum triglyceride and low-density lipoprotein (LDL) cholesterol levels in patients with type 2 diabetes mellitus (DM).

Methods: A total of 40 patients with type 2 DM, who were followed up regularly in the Endocrinology and Metabolism Out-patient Clinic of State Hospital, were evaluated retrospectively. In these patients, dapagliflozin was added to their regular treatment for glycemic control. The patients’ anthropometric measurements, glycemic regulation status, and serum LDL cholesterol and triglyceride levels were retrieved from the system records. A statistical analysis of drug effects was performed using the repeated measures analysis of covariance test, keeping the effects of HbA1c and body mass index (BMI) covariates constant.

Results: In addition to the improvement in fasting blood glucose levels, HbA1c, and body weight of the patients, a reduction by 10 mg/dL and 43.04 mg/dL was observed in serum LDL cholesterol and triglyceride levels, respectively. The evaluation of BMI and HbA1c covariates together revealed a statistically significant reduction in triglyceride levels (p=0.032 and p=0.008, respectively).

Conclusion: Besides glycemic control and weight loss, addition of dapagliflozin to the type 2 DM therapy is associated with an improvement in serum triglyceride levels, suggesting that together with other benefits, SGLT2 inhibitors appear to provide an additional benefit of reducing the risk of cardiovascular diseases.

Metrics

Metrics Loading ...

References

Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 2017; 38: 2459-72.

Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, DiAngelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 2010; 375: 2215-22.

American Diabetes Association. Cardiovascular disease and risk management. Diabetes care 2015; 38(Suppl): 549-57.

Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab 2009; 5: 150-9.

Fox CS, Golden SH, Anderson C, Bray GA, Burke LE, de Boer IH, et al. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence. A scientific statement

from the American heart association and the American diabetes association. Circulation 2015; 132: 691-718.

Jung CH, Jang JE, Park JY. A novel therapeutic agent for type 2 diabetes mellitus: SGLT2 inhibitor. Diabetes Metab J 2014; 38: 261-73.

Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, Cardiovascular Outcomes and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373: 2117-28.

Seon-Ah C, Yong-Moon P, Jae-Seung Y, Tae-Seok L, Ki-Ho S, Ki-Dong Y, 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.

Heise T, Seewaldt-Becker E, Macha S, Hantel S, Pinnetti S, Seman L, et al. Safety, tolerability, pharmacokinetics and pharmacodynamics following 4 weeks’ treatment with empagliflozin once daily in patients with type 2 diabetes. Diabetes Obes Metab 2013; 15: 613-21.

Yang W, Han P, Min KW, Wang B, Mansfield T, T'Joen C, et al. Efficacy and safety of dapagliflozin in Asian patients with type 2 diabetes after metformin failure: A randomized controlled trial. J Diabetes 2016; 8: 796-808.

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.

Lingvay I. Sodium glucose cotransporter 2 and dipeptidyl peptidase- 4 inhibition: promise of a dynamic duo. Endocr Pract 2017; 23: 831-40.

Boekholdt SM, Arsenault BJ, Mora S, Pedersen TR, LaRosa JC, Nestel PJ, et al. Association of LDL cholesterol, non-HDL cholesterol, and apolipoprotein B levels with risk of cardiovascular events among patients treated with statins: a meta-analysis. JAMA 2012; 307: 1302-9.

Robinson JG, Wang S, Jacobson TA. Meta-analysis of comparison of effectiveness of lowering apolipoprotein B versus low-density lipoprotein cholesterol and nonhigh-density lipoprotein cholesterol

for cardiovascular risk reduction in randomized trials. Am J Cardiol 2012; 110: 1468-76.

Brown MS, Goldstein JL. A proteolytic pathway that controls the cholesterol content of membranes, cells, and blood. Proc Natl Acad Sci USA 1999; 96: 11041-8.

Briand F, Mayoux E, Brousseau E, Burr N, Urbain I, Costard C, et al. Empagliflozin, via switching metabolism toward lipid utilization, moderately increases LDL cholesterol levels through reduced LDL catabolism. Diabetes 2016; 65: 2032-8.

Inzucchi SE, Zinman B, Wanner C, Ferrari R, Fitchett D, Hantel S, et al. SGLT-2 inhibitors and cardiovascular risk: Proposed pathways and review of ongoing outcome trials. Diab Vasc Dis Res 2015; 12: 90- 100.

Cefalu WT. Paradoxical insights into whole body metabolic adaptations following SGLT2 inhibition. J Clin Invest 2014; 124: 485-7.