SGLT-2 Inhibitor Effects on Cardiac and Hepatic Metabolic Profiles for the Diabetes Patients Combined With Obesity
Status:
Completed
Trial end date:
2022-12-31
Target enrollment:
Participant gender:
Summary
Obesity is closely associated with an increased risk of cardiomyopathy because of the high
metabolic activity of excessive fat while effective treatment of obesity-related
cardiomyopathy is currently unsolved. Sodium-glucose cotransporter-2 inhibitors (SGLT2-i) are
a class of diabetic medications. Besides improving glucose control, SGLT2-i has been shown to
be able to reduce the bodyweight as well as the mortality and hospitalization rates for heart
failure and cardiovascular disease in the type 2 diabetes patients. It has been proposed that
the heart protection by SGLT2-i might be caused by modulating the production of adipokine and
cytokine. The investigators will enrolled 40 patients (diabetes mellitus with BMI>27 Kg/m2)
from obesity weight-reduction clinics: 1) 20 patients treated with SGLT2-i (CANA) and regular
weight-reduction plan; 2) 20 patients with regular weight reduction plan, without CANA, for 4
weeks. The investigators will compare the variation of Fibroblast growth factor-21 (FGF21)
related proteins and RNA between these 2 groups of subjects. The investigators will arrange
cardiac ultrasound, hepatic MRI and fibroscan, body composition dual energy x-ray
absorptiometry to evaluate the possible mechanisms underlying the liver and heart
modification process, as a scientific basis for precision medicine in the future.
Conclusions: SGLT2-i treatment may increase the concentration of FGF21, either in the liver
or heart, thus to protect the high-fat diet induced obesity associated heart dysfunction by
activating FGF21 downstream protein expression.