DLR-Logo -> http://www.dlr.de
DLR Portal Home | Imprint | Privacy Policy | Contact | Deutsch
Fontsize: [-] Text [+]

Randomized trial comparing SGLT2 inhibition and hydrochlorothiazide on sympathetic traffic in type 2 diabetes

Heusser, K. and Tank, J. and Diedrich, A. and Fischer, A. and Heise, T. and Jordan, J. (2023) Randomized trial comparing SGLT2 inhibition and hydrochlorothiazide on sympathetic traffic in type 2 diabetes. Kidney International Reports, 8 (11), pp. 2254-2264. Elsevier. doi: 10.1016/j.ekir.2023.08.036. ISSN 2468-0249.

[img] PDF - Published version

Official URL: https://doi.org/10.1016/j.ekir.2023.08.036


Introduction Reductions in sympathetic nervous system activity may contribute to beneficial effects of sodium glucose cotransporter 2 (SGLT2) inhibition on cardiovascular outcomes. Therefore, we tested the hypothesis that SGLT2 inhibition with empagliflozin (Empa) lowers muscle sympathetic nerve activity (MSNA) in patients with type 2 diabetes mellitus (T2DM) compared with hydrochlorothiazide (HCT) to discern SGLT2-specific actions from responses to increased natriuresis. Methods We randomized patients with T2DM on metformin monotherapy to either 25 mg/d Empa (n = 20) or 25 mg/d HCT (n = 21) for 6 weeks in a parallel, double-blind fashion. We assessed MSNA by peroneal microneurography, blood pressure, cardiovascular and metabolic biomarkers at baseline and at the end of treatment. Results Both drugs elicited volume depletion, as indicated by increased thoracic impedance. Compared with HCT, Empa caused 1.23 kg more body weight loss (P = 0.011) and improved glycemic control. Seated systolic blood pressure decreased with both treatments (P < 0.002). MSNA did not change significantly with either treatment; however, MSNA changes were negatively correlated with changes in body weight on Empa (P = 0.042) and on HCT(P = 0.001). The relationship was shifted to lower MSNA on Empa compared with HCT (P = 0.002). Conclusion Increased renal sodium excretion eliciting body weight loss may promote sympathetic activation. However, sympathetic excitation in the face of increased sodium loss may be attenuated by SGLT2 inhibitor-specific actions.

Item URL in elib:https://elib.dlr.de/199805/
Document Type:Article
Title:Randomized trial comparing SGLT2 inhibition and hydrochlorothiazide on sympathetic traffic in type 2 diabetes
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
Heusser, K.UNSPECIFIEDhttps://orcid.org/0000-0002-2571-5585UNSPECIFIED
Tank, J.UNSPECIFIEDhttps://orcid.org/0000-0002-5672-1187UNSPECIFIED
Diedrich, A.Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Service, Vanderbilt University, Nashville, TNUNSPECIFIEDUNSPECIFIED
Fischer, A.Profil, Neuss, GermanyUNSPECIFIEDUNSPECIFIED
Jordan, J.UNSPECIFIEDhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Date:3 September 2023
Journal or Publication Title:Kidney International Reports
Refereed publication:Yes
Open Access:Yes
Gold Open Access:Yes
In ISI Web of Science:Yes
Page Range:pp. 2254-2264
Keywords:cardiovascular regulation; empagliflozin; hemodynamics; HCT; microneurography sympathetic activity
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine > Gravitational Biology
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:05 Dec 2023 14:32
Last Modified:07 Dec 2023 13:55

Repository Staff Only: item control page

Help & Contact
electronic library is running on EPrints 3.3.12
Website and database design: Copyright © German Aerospace Center (DLR). All rights reserved.