Abstract 16518: The Sodium Glucose Co-Transporter 2 Inhibitor (SGLT2i) Empagliflozin Reduces Weight and Markers of Visceral Adiposity (VA) in Type 2 Diabetes (T2D) in Short- and Intermediate Term
Excess VA is associated with increased risk of T2D and cardiovascular (CV) disease. Empagliflozin (EMPA), a SGLT-2i, increases urinary glucose excretion, and reduces blood pressure (BP) and body weight. We explored the impact of EMPA versus placebo on surrogate markers of VA in two T2D study cohorts with short- and intermediate-term exposure with analyses performed on individual patient data from the full analysis set (FAS). Cohort 1 had 823 patients with hypertension participating in a 12-week randomized ambulatory BP monitoring trial with mean (SD) age 60.2 (9.0) yrs, HbA1c 7.9 (0.7)%, office systolic BP (SBP) 142 (12) mmHg and BMI 32.6 (5.1) kg/m2. Cohort 2 pooled 2476 patients from four 24-week phase III randomized trials with age 55.6 (10.2) yrs, HbA1c 8.0 (0.9)%, office SBP 129 (15) mmHg and BMI 28.7 (5.5) m/kg2. Changes from baseline to study-end for HbA1c, body weight and three validated markers of VA (waist circumference (WC), index of central obesity (ICO; ratio WC/height), visceral adiposity index (VAI) (VAImen: (WC/[39.68 + (1.88 x BMI)] x (TG/1.03) x (1.31/HDL)); VAIwomen: (WC/[36.58 + (1.89 x BMI)] x (TG/0.81) x (1.52/HDL)), and changes in estimated total body fat (eTBF) using the YMCA-formula (eTBFmen: 100*(-98.42 + [4.15*WC] - [0.082*weight])/weight; eTBFwomen:100*(-76.76 + [4.15*WC] - [0.082*weight])/weight), were assessed. In both cohorts HbA1c was significantly reduced with EMPA (mean [SE]):-0.64% (0.04)/-0.65% (0.03); both p < 0.001). There were significantly greater reductions in body weight and markers of VA in the EMPA groups compared with placebo (Table); changes in eTBF did not reach statistical significance. These findings suggest that EMPA may directly reduce VA and potentially alter TBF beyond its effects on glycemia. The ongoing EMPA-REG OUTCOME™ trial (NCT01131676) will provide further insights into whether changes in body composition induced by EMPA are associated with CV risk reduction.
Author Disclosures: I. Neeland: None. D.K. McGuire: Consultant/Advisory Board; Modest; Boehringer-Ingelheim. R.J. Chilton: Consultant/Advisory Board; Modest; Boehringer-Ingelheim. S. Crowe: Employment; Significant; Boehringer-Ingelheim. S.S. Lund: Employment; Significant; Boehringer-Ingelheim. H. Woerle: Employment; Significant; Boehringer-Ingelheim. U.C. Broedl: Employment; Significant; Boehringer-Ingelheim. O. Johansen: Employment; Significant; Boehringer-Ingelheim.
- © 2014 by American Heart Association, Inc.