METHODS: Thirteen metformin-treated individuals with type 2 diabetes were randomized to once-daily empagliflozin 25 mg or placebo for 4 weeks in a crossover design. Skeletal muscle glucose and FFA uptake together with hepatic tissue FFA uptake were measured using [18F]FDG positron emission tomography/computed tomography (PET/CT) and [11C]palmitate PET/CT. Insulin secretion and action were estimated using the oral minimal model.
RESULTS: Empagliflozin did not affect glucose (0.73 ± 0.30 vs. 1.16 ± 0.64, μmol/g/min p = 0.11) or FFA (0.60 ± 0.30 vs. 0.56 ± 0.3, μmol/g/min p = 0.54) uptake in skeletal muscle. FFA uptake in the liver (21.2 ± 10.1 vs. 19 ± 8.8, μmol/100 ml/min p = 0.32) was unaffected. Empagliflozin increased total beta-cell responsivity (20 ± 8 vs. 14 ± 9, 10-9 min-1, p < 0.01) and glucose effectiveness (2.6 × 10-2 ± 0.3 × 10-2 vs. 2.4 × 10-2 ± 0.3 × 10-2, dL/kg/min, p = 0.02).
CONCLUSIONS: Despite improved beta-cell function and glucose tolerance, empagliflozin does not appear to affect skeletal muscle FFA or glucose uptake.
方法:在交叉设计中,将13名接受二甲双胍治疗的2型糖尿病患者随机分为每日一次25mg依帕列净或安慰剂,为期4周。使用[18F]FDG正电子发射断层扫描/计算机断层扫描(PET/CT)和[11C]棕榈酸酯PET/CT测量骨骼肌葡萄糖和FFA摄取以及肝组织FFA摄取。使用口服最小模型估计胰岛素分泌和作用。
结果:Empagliflozin不影响血糖(0.73±0.30vs.1.16±0.64,μmol/g/minp=0.11)或FFA(0.60±0.30vs.0.56±0.3,μmol/g/minp=0.54)在骨骼肌中的摄取。肝脏中的FFA摄取(21.2±10.1vs.19±8.8,μmol/100ml/minp=0.32)不受影响。Empagliflozin增加总β细胞反应性(20±8vs.14±9,10-9min-1,p<0.01)和葡萄糖有效性(2.6×10-2±0.3×10-2vs.2.4×10-2±0.3×10-2,dL/kg/min,p=0.02)。
结论:尽管改善了β细胞功能和葡萄糖耐量,依帕列净似乎不影响骨骼肌FFA或葡萄糖摄取。