Abstract

BackgroundIt is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease.Methods and resultsWe administered 100 mg of canagliflozin for 6 months to 13 patients with type 2 diabetes mellitus. We evaluated glycemic control, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, and skeletal muscle mass by using impedance methods, and EAT thickness by using echocardiography. Canagliflozin treatment for 6 months decreased hemoglobin A1c level from 7.1 ± 0.5% to 6.7 ± 0.6% (P < 0.05) and decreased EAT thickness from 9.3 ± 2.5 to 7.3 ± 2.0 mm (P < 0.001), along with a trend of decreasing VAT and SAT area. No association was found between any of these changes.ConclusionCanagliflozin reduced EAT thickness in patients with type 2 diabetes mellitus independent of its effect on lowering blood glucose, suggesting that canagliflozin may have an effect in preventing cardiovascular events in these patients (UMIN000021327).

Highlights

  • It is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease

  • Canagliflozin reduced EAT thickness in patients with type 2 diabetes mellitus independent of its effect on lowering blood glucose, suggesting that canagliflozin may have an effect in preventing cardiovascular events in these patients (UMIN000021327)

  • We demonstrated that canagliflozin reduces EAT at 3 and 6 months without affecting visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and muscle weight

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Summary

Introduction

It is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease. Epicardial adipose tissue (EAT) is associated with various cardiovascular risk factors such as body mass index and area of visceral adipose tissue, as well as with the severity of coronary artery disease (CAD) [1,2,3,4]. Selective sodium glucose co-transporter 2 (SGLT2) inhibitors improve glucose metabolism by inhibiting. Selective sodium glucose co-transporter 2 inhibitors reduce weight and the amount of visceral adipose tissue (VAT) by caloric elimination, and improve insulin resistance [9,10,11].

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