Laboratory of Vascular Biology and Atherosclerosis (Aterolab), State University of Campinas (Unicamp), Sao Paulo 13083-887, Brazil.
Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium.
Int J Mol Sci. 2024 Apr 8;25(7):4108. doi: 10.3390/ijms25074108.
Evolocumab and empagliflozin yield a modest rise in plasma high-density lipoprotein cholesterol (HDL-C) through unknown mechanisms. This study aims to assess the effect of evolocumab plus empagliflozin vs. empagliflozin alone on HDL subspecies isolated from individuals with type 2 diabetes mellitus (T2D). This post hoc prespecified analysis of the EXCEED-BHS3 trial compared the effects of a 16-week therapy with empagliflozin (E) alone or in combination with evolocumab (EE) on the lipid profile and cholesterol content in HDL subspecies in individuals with T2D divided equally into two groups of 55 patients. Both treatments modestly increased HDL-C. The cholesterol content in HDL subspecies 2a (7.3%), 3a (7.2%) and 3c (15%) increased from baseline in the E group, while the EE group presented an increase from baseline in 3a (9.3%), 3b (16%) and 3c (25%). The increase in HDL 3b and 3c was higher in the EE group when compared to the E group ( < 0.05). No significant interactive association was observed between changes in hematocrit and HDL-C levels after treatment. Over a 16-week period, empagliflozin with or without the addition of evolocumab led to a modest but significant increase in HDL-C. The rise in smaller-sized HDL particles was heterogeneous amongst the treatment combinations.
依洛尤单抗和恩格列净通过未知机制使血浆高密度脂蛋白胆固醇（HDL-C）适度升高。本研究旨在评估依洛尤单抗联合恩格列净与恩格列净单药治疗对 2 型糖尿病（T2D）患者分离的 HDL 亚类的影响。这项 EXCEED-BHS3 试验的事后预设分析比较了 16 周恩格列净（E）单药治疗或联合依洛尤单抗（EE）治疗对 T2D 患者血脂谱和 HDL 亚类胆固醇含量的影响，T2D 患者分为两组，每组 55 例。两种治疗均适度增加了 HDL-C。E 组 HDL 亚类 2a（7.3%）、3a（7.2%）和 3c（15%）的胆固醇含量自基线增加，而 EE 组 3a（9.3%）、3b（16%）和 3c（25%）自基线增加。与 E 组相比，EE 组 HDL 3b 和 3c 的增加更高（<0.05）。治疗后，红细胞压积和 HDL-C 水平的变化之间未观察到显著的交互关联。在 16 周期间，无论是否添加依洛尤单抗，恩格列净均可导致 HDL-C 适度但显著升高。较小 HDL 颗粒的增加在不同治疗组合中存在异质性。
