Journal of diabetes investigation 2017 11 28() doi 10.1111/jdi.12781
Remnant lipoproteins are thought to be atherogenic. Remnant-like particle cholesterol (RLP-C), which reflects the levels of various kinds of remnant lipoproteins in the blood, has a significant correlation with insulin resistance.
MATERIALS AND METHODS
In this study, we measured the effect of empagliflozin (EMPA) on the levels of RLP-C and investigated whether EMPA-mediated change in RLP-C is associated with a change in insulin resistance in type2 diabetic patients who have insulin resistance.
Patients were allocated to receive placebo (n = 51) or EMPA (n = 58) as an add-on treatment. Fasting blood samples were collected before and 12 weeks after this intervention. EMPA significantly decreased HbA1c, body weight, systolic blood pressure, plasma triglycerides, liver transaminases and estimated glomerular filtration rate (eGFR), and increased HDL-cholesterol. Furthermore, EMPA decreased RLP-C and HOMA-R. In the placebo group, there were no significant changes in these factors except for slight increases in liver transaminases. Multiple regression analysis revealed that the change in HOMA-R (p = 0.0102) and the change in alanine aminotransferase (ALT) (p = 0.0301) were significantly associated with the change in RLP-C in the EMPA group. The change in RLP-C significantly correlated with the change in HOMA-R (Pearson correlation coefficient, 0.503 [95% CI, 0.199-0.719 ]; P=0.00241).
EMPA decreases RLP-C levels, which is closely associated with amelioration of insulin sensitivity in diabetic patients who have insulin resistance. This article is protected by copyright. All rights reserved.