Effects of SGLT2 Inhibitors on Circulating Cyclophilin A Levels in Patients with Type 2 Diabetes.

OBJECTIVE

This study aimed to evaluate cyclophilin (CypA) levels in patients with diabetes mellitus (DM) before and after treatment. Metabolic variables, such as weight, blood pressure, and plasma glucose, were assessed in these patients.

METHOD: This prospective cross-sectional study was conducted over 24 weeks. We included 38 patients with DM. After confirming the diagnosis of type 2 diabetes, SGLT2i (empagliflozin vs dapagliflozin) therapy was prescribed to the patients. Weight, body mass index (BMI), waist circumference, body fat ratio, fasting plasma glucose, glycated hemoglobin (HbA1c, %), and CypA levels were measured at 0, 12, and 24 weeks. Patients in the drug subgroup were divided into 2 groups: Empagliflozin (Empa, n=16) and Dapagliflozin (Dapa, n=22).

RESULTS

Weight (p<0.001), body mass index (p<0.001), percentage of body fat (p<0.001), diastolic blood pressure (p=0.006), fasting plasma glucose (p<0.001), HbA1c (p<0.001), serum creatinine (p<0.001), and CypA (p<0.001) levels after the SGLT2i therapy were statistically decreased compared to pre-treatment values in all patients. When comparing drug subgroups, significant decreases in weight (p=0.013) and percentage body fat (p=0.01) were observed in the Empa group compared with the Dapa group at 24 weeks. Changes in FPG (p=0.399), HbA1c (p=0.102), and CypA (p=0.329) between the two groups seemed to be similar.

CONCLUSION

Beyond the improvement of metabolic parameters, SGLT2 treatment reduced CypA levels in patients with DM regardless of drug subgroups. These drugs may further prevent the presence of cardiovascular diseases.