The effect of empagliflozin on fractalkine levels in patients with type 2 diabetes mellitus
Abstract
Type 2 diabetes mellitus (T2DM) is characterized by chronic hyperglycemia and low grade systemic inflammation. Among chemokines involved in diabetic inflammation, CX3CL1 (fractalkine) plays a prominent role: elevated levels are linked to insulin resistance and vascular complications. Sodium–glucose co transporter 2 (SGLT2) inhibitors, particularly empagliflozin, not only lower glucose but also exert anti inflammatory effects that may modulate CX3CL1.
Objective — to evaluate the effect of empagliflozin compared with standard therapy on fractalkine (CX3CL1) and glycated hemoglobin levels in T2DM patients with varying body mass index and to determine whether the effect on CX3CL1 is mediated by changes in HbA1c.
Materials and methods. A prospective study enrolled 110 adults with T2DM divided by body mass index (BMI): group I (normal weight, n=30), group II (overweight, n=40) and group III (obesity, n=40). Each group was randomised into subgroups A (standard therapy: lifestyle modification, diet, 200 min/week moderate intensity walking, metformin 850—2000 mg/day and statins) or B (standard therapy plus empagliflozin 10 mg/day for six months). HbA1c was measured by high performance liquid chromatography; CX3CL1 was quantified using a solid phase sandwich ELISA. Changes in biomarkers were analysed, percentage reductions were calculated and a linear regression (mediation analysis) evaluated whether HbA1c change mediated the effect on CX3CL1.
Results. Baseline characteristics (mean…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 110 participants or records.
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