Gotzmann Michael, Henk Pauline, Stervbo Ulrik, Blázquez-Navarro Arturo, Mügge Andreas, Babel Nina, Westhoff Timm H
University Hospital St Josef-Hospital, Cardiology and Rhythmology, Ruhr University Bochum, 44791 Bochum, Germany.
University Hospital Marien Hospital Herne, Medical Department 1, Ruhr University Bochum, 44625 Herne, Germany.
J Clin Med. 2023 Jul 3;12(13):4458. doi: 10.3390/jcm12134458.
The inhibition of sodium-glucose co-transporter 2 (SGLT-2) has been shown to be beneficial in the treatment of diabetic and non-diabetic patients with heart failure. The underlying mechanisms are incompletely understood. The present prospective study investigates for the first time the effect of empagliflozin on various soluble markers of inflammation in patients with reduced ejection fraction (HFrEF). We included 50 inpatients with HFrEF and diabetes mellitus type 2. A total of 25 patients received a therapy with the SGLT-2-inhibitor empagliflozin in addition to standard medication; the other 25 patients did not receive empagliflozin and were considered the control group. Quality of life, functional status and soluble immunological parameters in serum were assessed at baseline and after 3 months. The baseline characteristics of both groups revealed no significant differences. Patients on empagliflozin demonstrated a significant improvement in the Minnesota living with heart failure questionnaire (baseline 44.2 ± 20.2 vs. 24 ± 17.7; < 0.001), in distance in the 6-min walk test (baseline 343 ± 145 m vs. 450 ± 115 m; < 0.001) and in soluble interleukin-6 level (baseline 21.7 ± 21.8 pg/mL vs. 13.7 ± 15.8 pg/mL; = 0.008). There was no significant change of these or other parameters in the control group ( > 0.05 each). The empagliflozin-induced improvement of quality of life and functional capacity in patients with HFrEF and type 2 diabetes mellitus is accompanied by a substantial reduction of interleukin-6 levels. Thus, anti-inflammatory effects may contribute to the benefits of SGLT-2-inhibitors in heart failure.
钠-葡萄糖协同转运蛋白2（SGLT-2）抑制已被证明对治疗糖尿病和非糖尿病心力衰竭患者有益。其潜在机制尚未完全明确。本前瞻性研究首次调查了恩格列净对射血分数降低（HFrEF）患者各种可溶性炎症标志物的影响。我们纳入了50例HFrEF合并2型糖尿病的住院患者。总共25例患者在标准药物治疗基础上接受SGLT-2抑制剂恩格列净治疗；另外25例患者未接受恩格列净治疗，被视为对照组。在基线和3个月后评估生活质量、功能状态以及血清中的可溶性免疫参数。两组的基线特征无显著差异。接受恩格列净治疗的患者在明尼苏达心力衰竭生活问卷方面有显著改善（基线44.2±20.2 vs. 24±17.7；<0.001），在6分钟步行试验中的距离方面有显著改善（基线343±145米 vs. 450±115米；<0.001），在可溶性白细胞介素-6水平方面有显著改善（基线21.7±21.8 pg/mL vs. 13.7±15.8 pg/mL；=0.008）。对照组这些参数或其他参数均无显著变化（各>0.05）。恩格列净引起的HFrEF合并2型糖尿病患者生活质量和功能能力的改善伴随着白细胞介素-6水平的大幅降低。因此，抗炎作用可能有助于SGLT-2抑制剂在心力衰竭治疗中的益处。
