Effect of Empagliflozin on Serum Ferritin and Its Relationship With Inflammatory Markers in Prediabetic and Diabetic Patients.

Background

This research is aimed at evaluating the effects of the SGLT2 inhibitor empagliflozin on inflammatory markers, some iron metabolism markers, and their interrelationships before and after using empagliflozin.

Methods

A quasiexperimental study was conducted on 44 prediabetic and Type 2 diabetic patients aged 18-65 years. The participants were among those treated at the clinic affiliated with Kerman Medical Sciences University between 2022 and 2023. The study included diabetic patients with HbA1c levels of 0.5%-1% higher than the therapeutic target who were not using blood sugar control medication. Each patient received a daily dose of 10 mg of empagliflozin for 3 months. Changes in serum levels of iron, total iron-binding capacity (TIBC), ferritin, transferrin saturation, inflammatory markers IL-6, C-reactive protein (CRP), and uric acid were measured before and 3 months after commencing empagliflozin.

Results

Three months after starting empagliflozin, the mean FPG and Hb A1c levels showed a drop (p < 0.05). The serum ferritin level decreased, and TIBC increased significantly (p < 0.05) following empagliflozin treatment. Additionally, the serum levels of CRP (p < 0.05), IL-6 (p < 0.001), and uric acid (p < 0.001) declined. Analysis of the correlation between serum ferritin level and IL-6 and uric acid before and after empagliflozin use revealed a positive correlation between serum ferritin and IL-6 (p = 0.04) and uric acid (p = 0.03). However, no significant correlation was observed between the change in ferritin and CRP levels (p = 0.22).

Conclusion

Following empagliflozin treatment, serum levels of ferritin and inflammatory markers interleukin-6, CRP, and uric acid declined, indicating a significant relationship between SGLT2 inhibition, inflammation, and iron metabolism. Furthermore, the correlation between ferritin and inflammatory markers suggests that reduced ferritin levels may result from reduced inflammation. Trial Registration: ClinicalTrials.gov identifier: IRCT20090317001774N10.