Effect of add-on therapy of dapagliflozin and empagliflozin on adipokines in type 2 diabetes mellitus

Abstract

Background: The alteration of adipokine secretion leads to the development of insulin resistance or impaired function of insulin in type 2 diabetes with obesity. The main objective of the study was to evaluate the effect of add-on therapy of dapagliflozin and empagliflozin on visceral fat-associated adipokines in inadequately controlled overweight and obese type 2 diabetic patients on metformin monotherapy. Methods: The study included 60 participants diagnosed with type 2 diabetes mellitus with overweight or obesity. The blood samples were taken before starting first-line therapy with metformin, 12 weeks after starting metformin therapy and 12 weeks after starting add-on therapy. The biochemical variables were analyzed using Cobas® 6000 analyzer. Hemoglobin A1c (HbA1c) level was measured with high-performance liquid chromatography (HPLC). Serum adipokines were estimated with enzyme-linked immunosorbent assay (ELISA). Results: The mean adiponectin level was significantly elevated with add-on therapy using dapagliflozin and empagliflozin (P < 0.001). The mean fatty-acid binding protein 4 (FABP4), retinol-binding protein 4 (RBP4) and visfatin levels were reduced considerably (P < 0.001). The mean HbA1c, fasting plasma glucose (FPG) and post-prandial blood glucose (PPBG) levels were reduced significantly with add-on therapy (P < 0.001). Lipid profile and creatinine were also altered significantly with the add-on therapy (P < 0.001). Conclusions: Add-on therapy of dapagliflozin and empagliflozin are beneficial to control the adipokines that regulate the visceral fat in overweight and obese type 2 diabetic patients. The effective therapeutic target to control adipokines with metabolic variables reduces body weight, obesity, cardiovascular risk and renal disease in type 2 diabetes.