Effect of sodium-glucose cotransporter 2 inhibitors on serum low-density lipoprotein cholesterol in Japanese patients with type 2 diabetes mellitus

Tasuku Imada; Naoto Katakami; Hirotaka Watanabe; Shuhei Nishina; Shugo Sasaki; Mitsuyoshi Takahara; Iichiro Shimomura; Tsunehiko Yamamoto

doi:10.1111/jdi.14179

Effect of sodium-glucose cotransporter 2 inhibitors on serum low-density lipoprotein cholesterol in Japanese patients with type 2 diabetes mellitus

J Diabetes Investig. 2024 Mar 8. doi: 10.1111/jdi.14179. Online ahead of print.

Authors

Tasuku Imada^{1

2}, Naoto Katakami², Hirotaka Watanabe², Shuhei Nishina¹, Shugo Sasaki², Mitsuyoshi Takahara³, Iichiro Shimomura², Tsunehiko Yamamoto¹

Affiliations

¹ Department of Diabetes and Endocrinology, Kansai-Rosai Hospital, Amagasaki City, Hyogo, Japan.
² Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.
³ Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan.

PMID: 38459768
DOI: 10.1111/jdi.14179

Abstract

Aims/introduction: We aimed to evaluate factors that influence changes in blood low-density lipoprotein cholesterol (LDL-C) levels after treatment with sodium-glucose cotransporter 2 (SGLT2) inhibitors in Japanese patients with type 2 diabetes.

Materials and methods: We retrospectively analyzed clinical data of outpatients newly initiated on SGLT2 inhibitors (n = 176) and other oral antidiabetic drugs (n = 227). The patients were classified into four subgroups according to statin administration and baseline LDL-C levels (<120 or ≥120 mg/dL). Clinical characteristics were compared among the subgroups. Multivariate analysis was carried out to identify factors contributing to changes in LDL-C.

Results: The median follow-up period was 13.0 weeks (range 11.9-14.1 weeks, min 8 weeks, maximum 16 weeks) in the SGLT2i group, and 12.0 weeks (range 10.0-14.0 weeks, min 8 weeks, maximum 16 weeks) in the control group. Both groups showed a significant decrease in LDL-C (SGLT2i group -3.8 ± 24.7 mg/dL, control group -3.4 ± 15.0 mg/dL). Multivariate regression analyses showed that in both groups, the change in LDL-C depended on statin use and baseline LDL-C levels. Stratified analyses showed that LDL-C level was significantly decreased in statin users with baseline LDL-C ≥120 mg/dL (from 148.9 ± 33.5 to 109.3 ± 17.9 mg/dL, P = 0.002), and significantly increased in statin non-users with baseline LDL-C <120 mg/dL (from 96.3 ± 27.3 to 104.7 ± 24.8 mg/dL, P = 0.002). These changes were more characteristic for SGLT2 inhibitors than for other oral antidiabetic drugs (P for interaction = 0.010 and <0.001, respectively).

Conclusions: LDL-C levels and statin medication at baseline influence changes in LDL-C after SGLT2 inhibitors treatment in Japanese patients with type 2 diabetes.

Keywords: Low-density lipoprotein cholesterol; Sodium-glucose cotransporter 2 inhibitor; Type 2 diabetes mellitus.