A randomized clinical trial evaluating the effect of empagliflozin on triglycerides in obese adults: Role of visceral fat

Metabolism Open

Eunsook S. Jin¹  Min Hee Lee²  Craig R. Malloy²  Connor Hughes³  Ian J. Neeland⁴  Natalia de Albuquerque Rocha⁵ 

[1] Department of Internal Medicine, University of Texas Southwestern Medical Center, USA;Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA;Department of Internal Medicine, University of Texas Southwestern Medical Center, USA;Department of Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA;Essentia Health Heart and Vascular Center, Duluth, MN, USA;

关键词: SGLT2 inhibitor;    Visceral fat;    Glycerol;    Triglycerides;    Glyceroneogenesis;    NMR;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Empagliflozin, a sodium glucose cotransporter 2 inhibitor, is a medication to treat type 2 diabetes. The effect of empagliflozin in persons without diabetes has received less attention. Here we conducted a randomized, double-blind placebo-controlled clinical trial to examine the effect of empagliflozin on plasma triglycerides in obese non-diabetic adults. Methods: Participants (n = 35; BMI ≥ 30 kg/m2) underwent body composition assessments using MRI, and were randomly assigned to either placebo or empagliflozin (10 mg/d) for three months. At the baseline and post-treatment visit, after an overnight fast, blood was drawn for biochemical analysis. Participants received [U–13C3]glycerol orally followed by multiple blood draws over 3 h to examine glycerol incorporation into triglycerides using NMR spectroscopy. Results: The changes in blood triglyceride concentration with empagliflozin therapy related to the mass of baseline visceral adipose tissue (VAT; r = 0.53, p = 0.04). Empagliflozin slightly lowered triglycerides in obese subjects with low VAT, but increased triglycerides in the subjects with high VAT. Consistently, empagliflozin effectively suppressed triglyceride synthesis following [U–13C3]glycerol administration in the subjects with low VAT (p < 0.05), but not in the subjects with high VAT. The subjects with high VAT lost body weight after three months of empagliflozin treatment. In all subjects, about 20% of the triglyceride backbone originated from mitochondrial metabolism of glycerol. Conclusions: The effect of empagliflozin on triglycerides in obese adults differed depending on VAT. Empagliflozin suppressed triglyceride synthesis in the subjects with low VAT, but tended to increase triglycerides in those with high VAT.

【 授权许可】

Unknown