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Effects of Dapagliflozin on Epicardial Fat Thickness in Patients with Type 2 Diabetes and Obesity
Author(s) -
Iacobellis Gianluca,
GraMenendez Silvia
Publication year - 2020
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22798
Subject(s) - dapagliflozin , medicine , metformin , weight loss , type 2 diabetes , placebo , type 2 diabetes mellitus , diabetes mellitus , endocrinology , obesity , urology , alternative medicine , pathology
Objective Epicardial adipose tissue (EAT) thickness is a marker of visceral fat and an emerging therapeutic target. Dapagliflozin, a selective sodium‐glucose cotransporter 2 inhibitor, improves glucose control and induces moderate weight loss in patients with type 2 diabetes mellitus. Dapagliflozin has recently been shown to reduce cardiovascular risk. Nevertheless, whether dapagliflozin could reduce EAT thickness is unknown. Methods This hypothesis was tested in a 24‐week, randomized, double‐blind, placebo‐controlled clinical trial in 100 patients with type 2 diabetes mellitus with BMI ≥ 27 kg/m 2 and a hemoglobin A1c level ≤ 8% on metformin monotherapy. Individuals were randomly assigned to 2 groups to receive additional dapagliflozin up to 10 mg once daily or to remain on metformin up to 1,000 mg twice daily. Ultrasound‐measured EAT thickness was measured at baseline, 12 weeks, and 24 weeks. Results In the dapagliflozin group, EAT decreased by 20% from baseline to 24 weeks, by 15% after 12 weeks, and by 7% between 12 and 24 weeks, respectively ( P < 0.01 for all), whereas in the metformin group, there was a significant but smaller EAT reduction. There was no statistically significant correlation between EAT and body weight changes. Conclusions Dapagliflozin causes a rapid and significant EAT reduction that could be independent of weight loss.