Evaluation of the Effect of Dapagliflozin on CRP Levels in Type 2 Diabetes Patients

Authors

  • Boshra Yosef Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tishreen University, Syria.
  • Nisrin Kaddar Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Tishreen University, Syria.
  • Arige Boubou Department of Internal Medicine (Endocrinology), Faculty of Medicine, Tishreen University, Syria

DOI:

https://doi.org/10.35516/jjps.v16i2.1331

Keywords:

Type 2 diabetes mellitus (T2DM), Dapagliflozin, CRP, inflammation

Abstract

Type 2 diabetes mellitus (T2DM) is an increasingly prevalent chronic disease that associates with an increased risk of micro-and macrovascular complications. There is persuasive evidence that dapagliflozin may reduce chronic inflammation besides its glucose-lowering effect, which in term prevents the development of the disease and its complications. Therefore, this study aims to evaluate the effects of dapagliflozin on the inflammatory marker C-reactive protein (CRP) levels in T2DM patients. Patients with T2DM were randomly assigned into two groups, group 1 (n=52) receiving a daily dose of dapagliflozin as an add-on therapy with oral antihyperglycemic agents, and group 2 (control, n=60) who received oral antihyperglycemic agents (Metformin, Sulfonylureas, Thiazolidinediones, and Gliptins). After six months, our results showed a significant change in CRP levels from baseline after receiving dapagliflozin compared to the control. Although the reduction level of CRP was statically significant with both 5 mg and 10 mg doses, it was higher with the latter one.  In addition, the reduction in CRP levels was statistically significant in both controlled and uncontrolled, but more important in uncontrolled disease. An insignificant positive correlation was seen between HbA1c and CRP on admission (r: 0.21, p: 0.1) and during the follow-up period, at 3 months (r: 0.10, p: 0.4) and 6 months (r: 0.08, p: 0.5). Our study showed that dapagliflozin has a beneficial effect on inflammation by reducing CRP levels CRP in patients with T2DM.

Author Biographies

Boshra Yosef, Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tishreen University, Syria.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tishreen University, Syria.

Nisrin Kaddar, Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Tishreen University, Syria.

Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Tishreen University, Syria.

Arige Boubou, Department of Internal Medicine (Endocrinology), Faculty of Medicine, Tishreen University, Syria

Department of Internal Medicine (Endocrinology), Faculty of Medicine, Tishreen University, Syria

References

Dedoussis G., Kaliora A. and Panagiotakos D. Genes. Diet and Type 2 Diabetes Mellitus: A Review. Rev. Diabet. Stud. 2007; 4:13.

Xu G., Liu B., Sun Y. Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. BMJ. 2018; 362: 1497.

Zheng Y., Ley S., Hu F. Global etiology and epidemiology of type 2 diabetes mellitus and its complications. Nat. Rev. Endocrinol. 2018; 14:88-98.

Shoelson S., Lee J. and Goldfine A. Inflammation and insulin resistance. J. Clin. Investig. 2006; 116: 1793-1801.

Kasabri V. Uric Acid Relationship with Noninsulin-Based Insulin Resistance Indices in Selected Metabolic Disorders: A Systematic Critical Review. Jordan J. Pharm. Sci. 2021; 14(3).

Pepys M., Hirschfield G. C-reactive protein: a critical update. J. Clin. Investig. 2003; 111:1805-12.

Khawaja, N., et al. Evaluation of oxytocin (OXT), endothelin-1 and nesfatin plasma concentrations in newly-diagnosed diabetic and non-diabetic patients with metabolic syndrome. Jordan J. Pharm. Sci. 2016; 9(3).

Neumiller J., White J., Campbell R. Sodium glucose co transport inhibitors: progress and therapeutic potential in type 2 diabetes mellitus. Drug. 2010; 70:377-385.

Vasilkou D., Karagiannis T., Athanasiadou E. Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: a systematic review and meta-analysis. Ann. Intern. Med. 2013; 159:262-274.

Shigiyama F., Kumashiro N. Effectiveness of dapagliflozin on vascular endothelial function and glycemic control in patients with early-stage type 2 diabetes mellitus: DEFENCE study. Cardiovasc. Diabetol. 2017; 16:1-12.

Tang L., Wu Y. Dapagliflozin slows the progression of the renal and liver fibrosis associated with type 2 diabetes. Am. J. Physiol. Endocrinol. Metab. AM J. 2017; 313: E563-E576.

Lymperopoulos A., Borges J., Cora N. Sympatholytic mechanisms for the beneficial cardiovascular effects of SGLT2 inhibitors: a research hypothesis for Dapagliflozin’s effects in the adrenal gland. Int. J. Mol. Sci. 2021; 22: 7684.

Leng W., Ouyang X. The SGLT-2 inhibitor dapagliflozin has a therapeutic effect on atherosclerosis in diabetic ApoE−/− mice. Mediators of inflammation. 2016.

Lee D. SGLT2 inhibition via dapagliflozin improves generalized vascular dysfunction and alters the gut microbiota in type 2 diabetic mice. Cardiovasc. Diabetol. 2018; 17: 1-14.

Wang W., Li Z. Dapagliflozin improves cardiac function, remodeling, myocardial apoptosis, and inflammatory cytokines in mice with myocardial infarction. J. Cardiovasc. Transl. Res. 2021; 1-11.

Kang Y., Zhang F., Liu Z. Anti-inflammatory effects of sodium glucose co-transporter 2 inhibitors on atherosclerosis. Vascul. Pharmacol. VASC. 2020; 133:106779.

Okamo A., Yokokawa H., Naito T. Changes in levels of biomarkers associated with adipocyte function and insulin and glucagon during treatment with dapagliflozin among obese type 2 diabetes mellitus patients. Drug. R. D. 2016; 16:255-261.

Chen H., Tran D., Yang H. Dapagliflozin and ticagrelor have additive effects on the attenuation of the activation of the NLRP3 inflammasome and the progression of diabetic cardiomyopathy: an AMPK-mTOR interplay. Cardiovasc. Drugs. 2020; 34:443-461.

Xue L., Yuan X., Zhao X. Investigating the effects of dapagliflozin on cardiac function, inflammatory response and cardiovascular outcome in patients with STEMI Complicated with T2DM after PCI. eCAM. 2021; 1-6.

Alhwiesh A., Nasreldin M. The use of SGLT2 inhibitors in peritoneal dialysis patients: a shade of light on dapagliflozin. Arch. Nephrol. Urol. 2022; 5:1-8.

Zainordin N., Hatta S., Mohamed Shah F., Rahman T., Ismail N. and Abdul Ghani R. Effects of dapagliflozin on endothelial dysfunction in type 2 diabetes with established ischemic heart disease (EDIFIED). J. Clin. Endocrinol. Metab. 2020; 4:bvz017.

Downloads

Published

2023-06-25

How to Cite

Yosef, B., Kaddar, N., & Boubou, A. (2023). Evaluation of the Effect of Dapagliflozin on CRP Levels in Type 2 Diabetes Patients. Jordan Journal of Pharmaceutical Sciences, 16(2), 313–321. https://doi.org/10.35516/jjps.v16i2.1331

Issue

Section

Articles