Research Article
The effect of empagliflozin on monocyte high-density lipoprotein ratio in patients with type 2 diabetes mellitus
Abstract
Aim: We aimed to investigate the effect of empagliflozin, which is started in patients with type 2 diabetes mellitus (T2DM), on neutrophil leumphocyte ratio (NLR) and monocyte high-density lipoprotein ratio (MHR), which are used as inflammation, glycemic control and oxidative markers.
Material and Method: The file systems of T2DM patients who used empagliflozin for at least 12 weeks were retrospectively analyzed. Demographic data of the patients were recorded. biochemical and hemogram parameters were compared before and after empagliflozin.
Results: 194 patients were included in the study. Plasma fasting glucose (p<0.001), hemoglobin A1c (HbA1c)(p<0.001), low-density lipoprotein cholesterol (LDL-C) (p=0.041), NLR(p=0.002) and MHR(p=0.042) values of T2DM patients after empagliflozin treatment were statistically significantly decreased compared to pre-treatment with empagliflozin. HDL-C value(p=0.003), on the other hand, increased significantly after empagliflozin
Conclusion: NLR and MHR are inexpensive and practical markers of inflammation. This result shows us that NLR and MHR should be used as inflammation markers in patients using empagliflozin.
Keywords
References
- J Levine M. Empagliflozin for type 2 diabetes mellitus: an overview of phase 3 clinical trials. Curr Diab Rev 2017; 13: 405-23.
- Xu T, Weng Z, Pei C, et al. The relationship between neutrophil-to-lymphocyte ratio and diabetic peripheral neuropathy in type 2 diabetes mellitus. Medicine (Baltimore) 2017; 96: 8289.
- Liu S, Zheng H, Zhu X, Mao F, Zhang S, Shi H. Neutrophil-to-lymphocyte ratio is associated with diabetic peripheral neuropathy in type 2 diabetes patients. Diabetes Res Clin Pract 2017; 130: 90-7.
- De Rooij SR, Nijpels G, Nilsson PM, Nolan JJ, Gabriel R, Bobbioni-Harsch E. Low-grade chronic inflammation in the relationship between insulin sensitivity and cardiovascular disease (RISC) population: associations with insulin resistance and cardiometabolic risk profile. Diabetes Care 2009; 32: 1295-301.
- Qiao S, Gao W, Guo S. Neutrophil–lymphocyte ratio (NLR) for predicting clinical outcomes in patients with coronary artery disease and type 2 diabetes mellitus: a propensity score matching analysis. Therapeutics and Clinical Risk Management 2020; 16: 437-43.
- You S, Zhong C, Zheng D, Xu J, Zhang X, Liu H. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci 2017; 372: 157-61.
- Vural G, Gümüsyayla Ş. Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine 2018; 97: 12857.
- Byrne NJ, Parajuli N, Levasseur JL, et al. Empagliflozin prevents worsening of cardiac function in an experimental model of pressure overload-induced heart failure. JACC Basic Transl Sci 2017; 2: 347–54.
- Li C, Zhang J, Xue M, et al. SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart. Cardiovascr Diabetol 2019; 18: 1-13.
- Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nat Rev Endocrinol 2011; 8: 228–36.
- Diyabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu. 2020: Türkiye Endokrinoloji ve Metabolizma Derneği.
- J Levine M. Empagliflozin for type 2 diabetes mellitus: an overview of phase 3 clinical trials. Curr Diab Rev 2017; 13: 405-23.
- Rosenstock J, Seman LJ, Jelaska A, et al. Efficacy and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, as add‐on to metformin in type 2 diabetes with mild hyperglycaemia. Diabetes, Obesity and Metabolism 2013; 15: 1154-60.
- Nagahisa T, Saisho Y. cardiorenal protection: Potential of sglt2 inhibitors and glp-1 receptor agonists in the treatment of type 2 diabetes. Diabetes Ther 2019; 10: 1733–52.
- Monami M, Nardini C, Mannucci E. Efficacy and safety of sodium glucose co-transport-2 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 2014; 16: 457–66.
- Hardy E, Ptanszynska A, de Bruin TWA. Changes in lipid profiles of patients with type 2 diabetes mellitus on dapagliflozin therapy. Diabetologia 2013; 56: 233.
- Tentolouris A, Vlachakis P, Tzeravini E, Eleftheriadou I, Tentolouris N. SGLT2 inhibitors: a review of their antidiabetic and cardioprotective effects. Int J Environ Res Public Health 2019; 16: 2965.
- Hach T, Gerich J, Salsali A, et al. Empagliflozin improves glycemic parameters and cardiovascular risk factors in patients with type 2 diabetes (T2DM): pooled data from four pivotal phase III trials. Diabetologie und Stoffwechsel 2014; 9: 142.
- Seko Y, Sumida Y, Tanaka S, et al. Effect of sodium glucose cotransporter 2 inhibitor on liver function tests in Japanese patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus. Hepatology Research 2017; 47: 1072-8.
- Shiny A, Bibin YS, Shanthirani CS, et al. Association of neutrophillymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther 2014; 16: 524–30.
- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pakistan J Med Sci 2019; 35: 1081-6.
- Canet F, Iannantuoni F, Marañon AMD, et al. Does empagliflozin modulate leukocyte–endothelium ınteractions, oxidative stress, and ınflammation in type 2 diabetes? Antioxidants 2021; 10: 1228.
- Singh RB, Fatima G, Kumar P, et al. Effects of empagliflozin on proinflammatory cytokines and other coronary risk factors in patients with type 2 diabetes mellitus: A single-arm real-world observation. Int J Clin Pharmacol Therapeutics 2021; 59: 17.
- Wan H, Wang Y, Fang S, et al. Associations between the neutrophil-to-lymphocyte ratio and diabetic complications in adults with diabetes: a cross-sectional study. J Diabetes Res 2020; 2020: 9.
- Chen JW, Li C, Liu ZH, et al. The role of monocyte to high-density lipoprotein cholesterol ratio in prediction of carotid intima-media thickness in patients with type 2 diabetes. Frontiers in Endocrinology 2019; 10: 191.
- Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. New Engl J Med 2015; 373: 2117-28.
- Feldman EL, Callaghan BC, Pop-Busui R, et al. Diabetic neuropathy. Nat Rev Dis Primers 2019; 5: 41.
- Winocour PH. Diabetes and chronic kidney disease: An increasingly common multi-morbid disease in need of a paradigm shift in care. Diabet. Med. 2018; 35: 300–5.
- Öztürk ZA, Kuyumcu ME, Yesil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013; 36: 593-9.
- DiGangi C. Neutrophil‐lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes. Journal of the American Association of Nurse Practitioners 2016; 28: 410-4.
- Feldman EL, Nave KA, Jensen TS, Bennett DLH. New horizons in diabetic neuropathy: mechanisms, bioenergetics, and pain. Neuron 2017; 93: 1296–313.
- Eid S A, O’Brien PD, Hinder LM, et al. Differential effects of empagliflozin on microvascular complications in murine models of type 1 and type 2 diabetes. Biology 2020; 9: 347.
- Mehta S, Nain P, Agrawal BK, et al. Effectiveness of empagliflozin with vitamin D supplementation in peripheral neuropathy in type 2 diabetic patients. Cureus 2021; 13: 12.
Year 2022,
Volume: 4 Issue: 3, 255 - 259, 26.07.2022
Abstract
References
- J Levine M. Empagliflozin for type 2 diabetes mellitus: an overview of phase 3 clinical trials. Curr Diab Rev 2017; 13: 405-23.
- Xu T, Weng Z, Pei C, et al. The relationship between neutrophil-to-lymphocyte ratio and diabetic peripheral neuropathy in type 2 diabetes mellitus. Medicine (Baltimore) 2017; 96: 8289.
- Liu S, Zheng H, Zhu X, Mao F, Zhang S, Shi H. Neutrophil-to-lymphocyte ratio is associated with diabetic peripheral neuropathy in type 2 diabetes patients. Diabetes Res Clin Pract 2017; 130: 90-7.
- De Rooij SR, Nijpels G, Nilsson PM, Nolan JJ, Gabriel R, Bobbioni-Harsch E. Low-grade chronic inflammation in the relationship between insulin sensitivity and cardiovascular disease (RISC) population: associations with insulin resistance and cardiometabolic risk profile. Diabetes Care 2009; 32: 1295-301.
- Qiao S, Gao W, Guo S. Neutrophil–lymphocyte ratio (NLR) for predicting clinical outcomes in patients with coronary artery disease and type 2 diabetes mellitus: a propensity score matching analysis. Therapeutics and Clinical Risk Management 2020; 16: 437-43.
- You S, Zhong C, Zheng D, Xu J, Zhang X, Liu H. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci 2017; 372: 157-61.
- Vural G, Gümüsyayla Ş. Monocyte-to-high density lipoprotein ratio is associated with a decreased compound muscle action potential amplitude in patients with diabetic axonal polyneuropathy. Medicine 2018; 97: 12857.
- Byrne NJ, Parajuli N, Levasseur JL, et al. Empagliflozin prevents worsening of cardiac function in an experimental model of pressure overload-induced heart failure. JACC Basic Transl Sci 2017; 2: 347–54.
- Li C, Zhang J, Xue M, et al. SGLT2 inhibition with empagliflozin attenuates myocardial oxidative stress and fibrosis in diabetic mice heart. Cardiovascr Diabetol 2019; 18: 1-13.
- Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus–present and future perspectives. Nat Rev Endocrinol 2011; 8: 228–36.
- Diyabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Klavuzu. 2020: Türkiye Endokrinoloji ve Metabolizma Derneği.
- J Levine M. Empagliflozin for type 2 diabetes mellitus: an overview of phase 3 clinical trials. Curr Diab Rev 2017; 13: 405-23.
- Rosenstock J, Seman LJ, Jelaska A, et al. Efficacy and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, as add‐on to metformin in type 2 diabetes with mild hyperglycaemia. Diabetes, Obesity and Metabolism 2013; 15: 1154-60.
- Nagahisa T, Saisho Y. cardiorenal protection: Potential of sglt2 inhibitors and glp-1 receptor agonists in the treatment of type 2 diabetes. Diabetes Ther 2019; 10: 1733–52.
- Monami M, Nardini C, Mannucci E. Efficacy and safety of sodium glucose co-transport-2 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Diabetes Obes Metab 2014; 16: 457–66.
- Hardy E, Ptanszynska A, de Bruin TWA. Changes in lipid profiles of patients with type 2 diabetes mellitus on dapagliflozin therapy. Diabetologia 2013; 56: 233.
- Tentolouris A, Vlachakis P, Tzeravini E, Eleftheriadou I, Tentolouris N. SGLT2 inhibitors: a review of their antidiabetic and cardioprotective effects. Int J Environ Res Public Health 2019; 16: 2965.
- Hach T, Gerich J, Salsali A, et al. Empagliflozin improves glycemic parameters and cardiovascular risk factors in patients with type 2 diabetes (T2DM): pooled data from four pivotal phase III trials. Diabetologie und Stoffwechsel 2014; 9: 142.
- Seko Y, Sumida Y, Tanaka S, et al. Effect of sodium glucose cotransporter 2 inhibitor on liver function tests in Japanese patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus. Hepatology Research 2017; 47: 1072-8.
- Shiny A, Bibin YS, Shanthirani CS, et al. Association of neutrophillymphocyte ratio with glucose intolerance: an indicator of systemic inflammation in patients with type 2 diabetes. Diabetes Technol Ther 2014; 16: 524–30.
- Onalan E. The relationship between monocyte to high-density lipoprotein cholesterol ratio and diabetic nephropathy. Pakistan J Med Sci 2019; 35: 1081-6.
- Canet F, Iannantuoni F, Marañon AMD, et al. Does empagliflozin modulate leukocyte–endothelium ınteractions, oxidative stress, and ınflammation in type 2 diabetes? Antioxidants 2021; 10: 1228.
- Singh RB, Fatima G, Kumar P, et al. Effects of empagliflozin on proinflammatory cytokines and other coronary risk factors in patients with type 2 diabetes mellitus: A single-arm real-world observation. Int J Clin Pharmacol Therapeutics 2021; 59: 17.
- Wan H, Wang Y, Fang S, et al. Associations between the neutrophil-to-lymphocyte ratio and diabetic complications in adults with diabetes: a cross-sectional study. J Diabetes Res 2020; 2020: 9.
- Chen JW, Li C, Liu ZH, et al. The role of monocyte to high-density lipoprotein cholesterol ratio in prediction of carotid intima-media thickness in patients with type 2 diabetes. Frontiers in Endocrinology 2019; 10: 191.
- Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. New Engl J Med 2015; 373: 2117-28.
- Feldman EL, Callaghan BC, Pop-Busui R, et al. Diabetic neuropathy. Nat Rev Dis Primers 2019; 5: 41.
- Winocour PH. Diabetes and chronic kidney disease: An increasingly common multi-morbid disease in need of a paradigm shift in care. Diabet. Med. 2018; 35: 300–5.
- Öztürk ZA, Kuyumcu ME, Yesil Y, et al. Is there a link between neutrophil-lymphocyte ratio and microvascular complications in geriatric diabetic patients? J Endocrinol Invest 2013; 36: 593-9.
- DiGangi C. Neutrophil‐lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes. Journal of the American Association of Nurse Practitioners 2016; 28: 410-4.
- Feldman EL, Nave KA, Jensen TS, Bennett DLH. New horizons in diabetic neuropathy: mechanisms, bioenergetics, and pain. Neuron 2017; 93: 1296–313.
- Eid S A, O’Brien PD, Hinder LM, et al. Differential effects of empagliflozin on microvascular complications in murine models of type 1 and type 2 diabetes. Biology 2020; 9: 347.
- Mehta S, Nain P, Agrawal BK, et al. Effectiveness of empagliflozin with vitamin D supplementation in peripheral neuropathy in type 2 diabetic patients. Cureus 2021; 13: 12.
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Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | July 26, 2022 |
| Published in Issue | Year 2022 Volume: 4 Issue: 3 |
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