Berezin Alexander A, Obradovic Zeljko, Fushtey Ivan M, Berezina Tetiana A, Novikov Evgen V, Schmidbauer Lukas, Lichtenauer Michael, Berezin Alexander E
Internal Medicine Department, Zaporozhye Medical Academy of Postgraduate Education, 69000 Zaporozhye, Ukraine.
Department of Psychosomatic Medicine and Psychotherapy, Klinik Barmelweid, 5017 Barmelweid, Switzerland.
Biomedicines. 2023 Feb 4;11(2):457. doi: 10.3390/biomedicines11020457.
adropin plays a protective role in cardiac remodeling through supporting energy metabolism and water homeostasis and suppressing inflammation. Low circulating levels of adropin were positively associated with the risk of cardiovascular diseases and type 2 diabetes mellitus (T2DM). We hypothesized that sodium-glucose linked transporter 2 (SGLT2) inhibitor dapagliflosin might represent cardiac protective effects in T2DM patients with known chronic HF through the modulation of adropin levels.
we prospectively enrolled 417 patients with T2DM and HF from an entire cohort of 612 T2DM patients. All eligible patients were treated with the recommended guided HF therapy according to their HF phenotypes, including SGLT2 inhibitor dapagliflozin 10 mg, daily, orally. Anthropometry, clinical data, echocardiography/Doppler examinations, and measurements of biomarkers were performed at the baseline and over a 6-month interval of SGLT2 inhibitor administration.
in the entire group, dapagliflozin led to an increase in adropin levels by up to 26.6% over 6 months. In the female subgroup, the relative growth (Δ%) of adropin concentrations was sufficiently higher (Δ% = 35.6%) than that in the male subgroup (Δ% = 22.7%). A multivariate linear regression analysis of the entire group showed that the relative changes (Δ) in the left ventricular (LV) ejection fraction (LVEF), left atrial volume index (LAVI), and E/e' were significantly associated with increased adropin levels. In the female subgroup, but not in the male subgroup, ΔLVEF ( = 0.046), ΔLAVI ( = 0.001), and ΔE/e' ( = 0.001) were independent predictive values for adropin changes.
the levels of adropin seem to be a predictor for the favorable modification of hemodynamic performances during SGLT2 inhibition, independent ofN-terminal brain natriuretic pro-peptide levels.
内脂素通过支持能量代谢和水稳态以及抑制炎症，在心脏重塑中发挥保护作用。循环内脂素水平低与心血管疾病和2型糖尿病（T2DM）风险呈正相关。我们假设，钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂达格列净可能通过调节内脂素水平，对已知慢性心力衰竭的T2DM患者产生心脏保护作用。
我们从612例T2DM患者的整个队列中前瞻性纳入了417例T2DM合并心力衰竭患者。所有符合条件的患者根据其心力衰竭表型接受推荐的指导性心力衰竭治疗，包括每日口服10mg SGLT2抑制剂达格列净。在基线以及SGLT2抑制剂给药的6个月间隔内，进行人体测量、临床数据、超声心动图/多普勒检查以及生物标志物测量。
在整个组中，达格列净在6个月内使内脂素水平升高了26.6%。在女性亚组中，内脂素浓度的相对增长（Δ%）（Δ% = 35.6%）明显高于男性亚组（Δ% = 22.7%）。对整个组进行的多变量线性回归分析表明，左心室（LV）射血分数（LVEF）、左心房容积指数（LAVI）和E/e'的相对变化（Δ）与内脂素水平升高显著相关。在女性亚组中，而不是男性亚组中，ΔLVEF（ = 0.046）、ΔLAVI（ = 0.001）和ΔE/e'（ = 0.001）是内脂素变化的独立预测值。
内脂素水平似乎是SGLT2抑制期间血流动力学性能良好改善的预测指标，独立于N末端脑钠肽前体水平。
