Empagliflozin influences blood viscosity and wall shear stress in subjects with type 2 diabetes mellitus compared with incretin-based therapy

• Published in: Cardiovascular diabetology 2018-04, Vol.17 (1), p.52-52, Article 52
• Main Authors: Irace, Concetta, Casciaro, Francesco, Scavelli, Faustina Barbara, Oliverio, Rosa, Cutruzzolà, Antonio, Cortese, Claudio, Gnasso, Agostino
• Format: Article
• Language: English
• Subjects: Aged; Benzhydryl Compounds - therapeutic use; Blood viscosity; Blood Viscosity - drug effects; Carotid Artery, Common - diagnostic imaging; Carotid Artery, Common - drug effects; Carotid Artery, Common - physiopathology; Carotid Intima-Media Thickness; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Empagliflozin; Female; Glucosides - therapeutic use; Humans; Incretins - therapeutic use; Intima-plus media thickness; Liraglutide - therapeutic use; Male; Middle Aged; Original Investigation; Prospective Studies; Regional Blood Flow; Rheology; Shear stress; Sitagliptin Phosphate - therapeutic use; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Stress, Mechanical; Time Factors; Treatment Outcome
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/s12933-018-0695-y

Cardiovascular protection following empagliflozin therapy is not entirely attributable to the glucose lowering effect. Increased hematocrit might influence the shear stress that is the main force acting on the endothelium, regulating its anti-atherogenic function. We designed the study with the aim of investigating the effect of empagliflozin on blood viscosity and shear stress in the carotid arteries. A secondary endpoint was the effect of empagliflozin on carotid artery wall thickness. The study was a non-randomized, open, prospective cohort study including 35 type 2 diabetic outpatients who were offered empagliflozin or incretin-based therapy (7 liraglutide, 8 sitagliptin) in combination with insulin and metformin. Blood viscosity, shear stress and carotid wall thickness were measured at baseline and at 1 and 3 months of treatment. Blood viscosity was measured with a viscometer, and shear stress was calculated using a validated formula. Intima-media thickness (IMT) of the carotid artery was detected by ultrasound and was measured with dedicated software. Blood viscosity (4.87 ± 0.57 vs 5.32 ± 0.66 cP, p