2347-PUB: Relationship between Aging and Effects of SGLT2 Inhibitors on Glucose and Lipid Metabolisms and Hepatic Function in Japanese Patients with Type 2 Diabetes

Abstract

SGLT2 inhibitors (SGLT2is) have been found to improve blood glucose, HbA1c and triglyceride levels and also hepatic dysfunction in patients with type 2 diabetes. However, scarcely any studies have examined whether there are differences in the effects of SGLT2is according to patient age. In this study, we stratified the patients into 3 groups according to the age and investigated whether age influences the effects of SGLT2is on glucose and lipid metabolisms and hepatic function in these patients. The patients were stratified into the following 3 age groups: <50, 50 to 64, and ≥65 years. Five SGLT2is were administered for 6 months at the following doses: 2.5 mg/day luseogliflozin, 5 mg/day dapagliflozin, 20 mg/day tofogliflozin, 10 mg/day empagliflozin, and 100 mg/day canagliflozin. Blood samples were collected before and after the treatment to measure biochemical parameters. Significant decreases, compared to the baseline, of HbA1c, serum glucose and insulin, and HOMA-R were observed after the treatment with the SGLT2is in the <64 years age groups, but not the ≥65 years age group. With regard to the effects on lipid metabolism, increase in serum HDL cholesterol and decrease in LDL cholesterol/HDL cholesterol ratio were observed in the ≥65 years age group. In addition, hepatic function parameters improved significantly in the <64 years age groups, but to a lesser degree in the ≥65 years age group. The effects on BMI were not affected. The results revealed that some effects of SGLT2is were affected by aging. The SGLT2is improved glucose metabolism in the patients aged <64 years, but this effect was weaker in those aged ≥65 years. However, the SGLT2is led to a more anti-atherogenic serum lipid profile in patients aged ≥65 years than in those aged <65 years. In addition, it appears that the hepatic function-improving effect of SGLT2is decreases with age, especially in patients aged ≥65 years. The effects of SGLT2 inhibitors on BMI were not affected. Disclosure M. Kusunoki: Other Relationship; Self; Kaken Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd. Y. Natsume: Other Relationship; Self; Kaken Pharmaceutical Co., Ltd., Ono Pharmaceutical Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd. Y. Oshida: None. T. Miyata: Research Support; Self; Bayer AG, Daiichi Sankyo Company, Limited.