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Assessing early tubular protective effects of SGLT2 inhibitor empagliflozin against type 2 diabetes mellitus using functional magnetic resonance imaging

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Abstract

Aims

To observe the alterations in functional magnetic resonance imaging parameters in normoalbuminuric type 2 diabetic patients undergoing SGLT2 inhibitor empagliflozin treatment and investigate the early tubular protective effects of the inhibitor.

Methods

This study was performed in normoalbuminuric type 2 diabetes mellitus patients (UACR < 30 mg/g, eGFR ≥ 60 ml/min/1.73 m2). The patients were divided into the intervention group (empagliflozin) and the control group (27 cases each). The intervention group was treated with 10 mg/day empagliflozin tablets orally, while the control group had adjustments to their basic treatment stage. The patients were treated for 6 weeks.

Results

The baseline clinical data of the two groups were comparable (P˃0.05). The intervention group exhibited better improvements in blood lipid profiles and more significant reductions in blood uric acid levels compared to the control group (P < 0.05). The two groups had No significant difference in blood pressure changes (P˃0.05). Notably, the intervention group demonstrated a greater reduction in UACR and a more substantial decline in eGFR than the control group (P < 0.05). Regarding functional magnetic resonance imaging parameters, the MD value of the renal medulla region in the intervention group increased after treatment, while the MR2* value of the renal medulla region decreased (P < 0.05).

Conclusions

SGLT2 inhibitor empagliflozin can reduce UACR and eGFR levels in early type 2 diabetic patients with normal proteinuria. Moreover, empagliflozin therapy led to an increase in the MD value and a decrease in the MR2* value of the renal medulla, evidencing the early tubular protective effects of this therapy.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

None.

Funding

This study was supported by the Medical Research Foundation of Guangdong Province (Grant Number: B2023376)；Scientific research project of Guangdong Provincial Bureau of traditional Chinese Medicine (Grant Number: 20231083)；Guangzhou Science and Technology Planning Project (Grant Number: 2023A04J1909).

Author information

Author notes

  1. Chuangbiao Zhang and Beibei Zhu contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology, First Affiliated Hospital of **an University, No.613, Huangpu Avenue West, Guangzhou, 510630, Guangdong Province, China

    Chuangbiao Zhang, Lie Feng, Jiaying Li & **aohua Lu

  2. Endoscopy Center, First Affiliated Hospital of **an University, No.613, Huangpu Avenue West, Guangzhou, 510630, Guangdong Province, China

    Beibei Zhu

  3. Medical Imaging Center, First Affiliated Hospital of **an University, No.613, Huangpu Avenue West, Guangzhou, 510630, Guangdong Province, China

    Youzhen Feng, Zhongyuan Cheng & **angran Cai

Authors
  1. Chuangbiao Zhang
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  6. Lie Feng
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  7. Jiaying Li
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Contributions

JL and XL conceived and designed the experiments. CZ, BZ, and YF contributed significantly to the experiments. CZ, BZ, YF, ZC, and XC helped with the experiments and arranging the data. XC and LF performed the data analyses. CZ and BZ wrote the draft manuscript. JL and XL critically revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jiaying Li.

Ethics declarations

Conflict of interest

All authors declare that there are no conflicts of interest.

Ethical approval

The study protocol was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of **an University (approval no: JJ-202856-451). All patients agreed and signed informed consent.

Human accordance statement

All the authors confirm that all methods were carried out in accordance with relevant guidelines and regulations. Research involving human participants, human material, or human data, must have been performed in accordance with the Declaration of Helsinki.

Informed consent to participate

All the authors confirming that informed consent was obtained from all subjects and their legal guardians.

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Not applicable.

Additional information

This article belongs to the Topical Collection “Diabetic Nephropathy”, managed by Giuseppe Pugliese.

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Zhang, C., Zhu, B., Feng, Y. et al. Assessing early tubular protective effects of SGLT2 inhibitor empagliflozin against type 2 diabetes mellitus using functional magnetic resonance imaging. Acta Diabetol 61, 473–483 (2024). https://doi.org/10.1007/s00592-023-02220-x

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