What is the clinical evidence from this study?

Study design: Observational. Population: Type 2 diabetes mellitus (n=13). Intervention: Canagliflozin vs. Baseline. Primary outcome: Epicardial adipose tissue (EAT) thickness at 6 months (p=<0.001).

October 4, 2017Open Access

Canagliflozin reduces epicardial fat in patients with type 2 diabetes mellitus

Q: What are the key findings of this study?

Canagliflozin treatment for 6 months significantly decreased epicardial adipose tissue thickness from 9.3 mm to 7.3 mm in patients with type 2 diabetes mellitus.

Key Result

Canagliflozin treatment for 6 months significantly decreased epicardial adipose tissue thickness from 9.3 mm to 7.3 mm in patients with type 2 diabetes mellitus.

Study Design

Type

Observational (n=13)

Blinding

Open-label

Multicenter

Structured PICO

Does canagliflozin reduce epicardial adipose tissue thickness in patients with type 2 diabetes mellitus?

Population

13 patients with type 2 diabetes mellitus treated with 100 mg canagliflozin daily and followed for 6 months.

Intervention

Canagliflozin 100 mg administered for 6 months

Outcome

Epicardial adipose tissue (EAT) thickness evaluated by echocardiography at 6 monthssurrogate

Canagliflozin significantly reduced epicardial adipose tissue thickness in patients with type 2 diabetes mellitus, suggesting a potential mechanism for cardiovascular risk reduction independent of glycemic control.

Main Result

Absolute Event Rate: 7.3% vs 9.3%

p-value: p=<0.001

Limitations

Single-arm observational study with a small sample size
Patient selection bias and less statistical power due to patients' heterogeneity
Relatively short observational period
Could not exclude the effects of concomitant drugs that can affect glucose metabolism
Evaluated only EAT thickness and did not study the effect of canagliflozin on EAT volume

Abstract

BACKGROUND: It is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease. METHODS AND RESULTS: We administered 100 mg of canagliflozin for 6 months to 13 patients with type 2 diabetes mellitus. We evaluated glycemic control, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, and skeletal muscle mass by using impedance methods, and EAT thickness by using echocardiography. Canagliflozin treatment for 6 months decreased hemoglobin A1c level from 7.1 ± 0.5% to 6.7 ± 0.6% (P < 0.05) and decreased EAT thickness from 9.3 ± 2.5 to 7.3 ± 2.0 mm (P < 0.001), along with a trend of decreasing VAT and SAT area. No association was found between any of these changes. CONCLUSION: Canagliflozin reduced EAT thickness in patients with type 2 diabetes mellitus independent of its effect on lowering blood glucose, suggesting that canagliflozin may have an effect in preventing cardiovascular events in these patients (UMIN000021327).

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