Volume 13, Issue 11 pp. 847-856

EDITOR'S RECOMMENDATION

Beneficial effects of sodium glucose cotransporter 2 inhibitors on left ventricular mass in patients with diabetes mellitus

钠葡萄糖共转运体2抑制剂对糖尿病患者左心室重量的影响

Daisuke Kosugi,

Daisuke Kosugi

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Hidefumi Inaba,

Corresponding Author

Hidefumi Inaba

[email protected]

orcid.org/0000-0002-7718-734X

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

The First Department of Medicine, Wakayama Medical University, Wakayama, Japan

Correspondence

Hidefumi Inaba, The First Department of Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8509, Japan; Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama City, Wakayama 640-8558, Japan.

Email: [email protected]

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Yosuke Kaido,

Yosuke Kaido

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Saya Ito,

Saya Ito

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Tomonao Hirobata,

Tomonao Hirobata

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Mamoru Toyofuku,

Mamoru Toyofuku

Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Takaaki Matsuoka,

Takaaki Matsuoka

The First Department of Medicine, Wakayama Medical University, Wakayama, Japan

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Gen Inoue,

Gen Inoue

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Daisuke Kosugi,

Daisuke Kosugi

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Hidefumi Inaba,

Corresponding Author

Hidefumi Inaba

[email protected]

orcid.org/0000-0002-7718-734X

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

The First Department of Medicine, Wakayama Medical University, Wakayama, Japan

Correspondence

Email: [email protected]

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Yosuke Kaido,

Yosuke Kaido

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Saya Ito,

Saya Ito

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Tomonao Hirobata,

Tomonao Hirobata

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Mamoru Toyofuku,

Mamoru Toyofuku

Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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Takaaki Matsuoka,

Takaaki Matsuoka

The First Department of Medicine, Wakayama Medical University, Wakayama, Japan

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Gen Inoue,

Gen Inoue

Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan

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First published: 07 July 2021

https://doi.org/10.1111/1753-0407.13209

Citations: 3

Funding information: Wakayama Medical University

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Abstract

Background

Sodium glucose cotransporter 2 inhibitor (SGLT2i) has recently been suggested to reduce the risk of cardiovascular events. Left ventricular hypertrophy (LVH) is associated with cardiovascular events. Diabetic macroangiopathy is a crucial complication in patients with diabetes mellitus (DM). This study examined the effect of SGLT2i on LVH in patients with type 2 DM (T2DM).

Methods

The retrospective cohort study was conducted in consecutive outpatients with T2DM from 2010 to 2020. Left ventricular mass index (LVMI) was used as an indicator of LVH based on echocardiography. The minimum follow-up period was 1 year. After propensity score-matching for clinical profiles, patients who underwent annual echocardiography twice for a routine checkup and took SGLT2i were defined to the SGLT2i group, whereas patients without SGLT2 inhibitors were defined to the non-SGLT2 group. SGLT2i was administered after baseline echocardiography followed by a second examination.

Results

LVMI levels in the SGLT2i group (n = 169) significantly decreased from baseline compared with those in the non-SGLT2i group (n = 169), % changes in LVMI2.7(g/m^2.7) in median (interquartile ranges [IQR]) were − 7.7 (−18.7, 2.5) vs −3.6 (−14.3, 5.8), respectively, P = 0.017). In a subgroup analysis, LVMI levels in the patients who had LVH in the SGLT2i group more significantly decreased than those without LVH, % changes in LVMI2.7(g/m^2.7) in median (IQR) were −13.5 (−22.1, −2.4) vs −2.8 (−12.6, 9.8), respectively, P < 0.001).

Conclusions

SGLT2i treatment was shown to improve LVH in patients with T2DM and may play a pivotal role in the future treatment of diabetic cardiovascular complications.

摘要

背景

钠葡萄糖协同转运蛋白2抑制剂(SGLT2i)最近被认为可以降低心血管事件的风险。左心室肥厚(LVH)与心血管事件有关。糖尿病大血管病变是糖尿病患者的重要并发症。本研究观察了SGLT2i对2型糖尿病(T2DM)患者左室肥厚的影响。

方法

采用回顾性队列研究方法, 对2010~2020年门诊随访的2型糖尿病患者进行研究。超声心动图以左心室重量指数(LVMI)作为左心室肥厚的指标。最短随访时间为1年。在对临床资料进行倾向评分匹配后, 每年进行两次超声心动图常规检查, 服用SGLT2i的患者被定义为SGLT2i组, 而未服用SGLT2i的患者被定义为非SGLT2i组。在基线超声心动图检查后, 服用SGLT2i, 随后进行第二次检查。

结果

与非SGLT2i组比较, SGLT2i组左心室重量指数显著降低(P=0.017), LVMI2.7(g/m2.7)的中位数(四分位数范围)的变化百分比分别为-7.7(-18.7, 2.5)vs -3.6(-14.3, 5.8), P=0.017, 在亚组分析中, SGLT2i组中左室肥厚患者的左心室质量指数较无左心室肥厚的患者明显降低, LVMI2.7(g/m2.7) 中位数的变化百分比分别为-13.5(-22.1, -2.4)vs-2.8(-12.6, 9.8), P<0.001。

结论

SGLT2i治疗可改善T2DM患者的LVH, 并可能在未来糖尿病心血管并发症的治疗中发挥关键作用。

Open Research

DATA AVAILABILITY STATEMENT

The datasets in the manuscript are available from the corresponding authors on reasonable request.

Supporting Information

Filename	Description
jdb13209-sup-0001-FigureS1.jpgJPEG image, 338.6 KB	Fig. S1 Patient enrollment procedures are shown and described thoroughly in the method. Among consecutive outpatients at our department between 2010 and 2020, a total of consecutive 967 patients with type 2 DM (T2DM) were recruited in the study. Based on the inclusion and exclusion procedures as indicated, patients with sodium glucose cotransporter 2 inhibitor treatment (SGLT2i group, n = 169), and those who were not with SGLT2i treatment (non-SGLT2i group, n = 169) during the follow-up period were analyzed. *SGLT2i treatment was commenced after baseline echocardiography: median (interquartile range [IQR]) was 182 days (34, 331) in each patient. Patients then undertook second echocardiography: median (IQR) was 315 days (193, 484) later, represents total exposure to SGLT2i. DM, diabetes mellitus; US, echocardiography.
jdb13209-sup-0002-FigureS2.jpgJPEG image, 103.7 KB	Fig. S2 Box-and-whisker plots. Percentage of changes in left ventricular mass index (LVMI)2.7 from baseline to second echocardiography in the two groups is shown in the y axis (%).The patients were divided into those who had body mass index <25 or ≥ 25 in the sodium glucose cotransporter 2 inhibitor (SGLT2i) group and the non-SGLT2i group. They were examined by Kruskal-Wallis test. No significant differences in % changes in LVMI2.7 were observed among the four groups. Minimum, median, interquartile range, and maximum values are indicated. Average levels are shown as “x.”
jdb13209-sup-0003-TableS1.xlsxExcel 2007 spreadsheet , 11.4 KB	Table S1 Baseline characteristics of the patients before propensity matching
jdb13209-sup-0004-TableS2.xlsxExcel 2007 spreadsheet , 13.3 KB	Table S2 Changes of echocardiogram results, blood pressure, levels of HbA1c, and body mass index in patients treated with sodium glucose cotransporter 2 inhibitors (SGLT2i) in the presence or absence of left ventricular hypertrophy (LVH).

Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

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Citing Literature

Volume13, Issue11

November 2021

Pages 847-856

This article also appears in:

Highlights from the Editors 2021

Beneficial effects of sodium glucose cotransporter 2 inhibitors on left ventricular mass in patients with diabetes mellitus

钠葡萄糖共转运体2抑制剂对糖尿病患者左心室重量的影响

Abstract

Background

Methods

Results

Conclusions

摘要

背景

方法

结果

结论

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Information

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Beneficial effects of sodium glucose cotransporter 2 inhibitors on left ventricular mass in patients with diabetes mellitus

钠葡萄糖共转运体2抑制剂对糖尿病患者左心室重量的影响

Abstract

Background

Methods

Results

Conclusions

摘要

背景

方法

结果

结论

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Related

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