The combination of dapagliflozin and exercise exerted significant cardioprotective, antioxidant, anti-inflammatory, and antifibrotic effects in a rat model of diabetic cardiomyopathy.
Does the combination of dapagliflozin and exercise improve markers of diabetic cardiomyopathy in a rat model of type 2 diabetes?
In a rat model of diabetic cardiomyopathy, combining dapagliflozin with exercise provided superior antioxidant, anti-inflammatory, and antifibrotic benefits compared to either therapy alone.
One of the most prevalent cardiovascular problems linked with type 2 diabetes mellitus (T2DM) is diabetic cardiomyopathy (DCM). DCM is associated with myocardial oxidative stress, inflammation, apoptosis, suppressed autophagy, extracellular matrix remodeling, and fibrosis. The current study aims to investigate the protective effect of sodium-glucose transport 2 inhibitor (SGLT2i) dapagliflozin and/or exercise on DCM. Thirty adult male Sprague Dawley rats are used. T2DM is induced by a 6-week high-fat diet (HFD) followed by a single intraperitoneal (IP) injection of 35 mg/kg streptozotocin (STZ). Rats are divided into five groups, control, diabetic (DM), DM + swimming, DM + dapagliflozin, and DM + dapagliflozin and swimming. Serum glucose, insulin, insulin resistance (HOMA-IR), and cardiac enzymes (CK-MB and lactate dehydrogenase (LDH) are measured. Heart specimens are used for evaluation of cellular oxidative stress markers malondialdehyde (MDA), antioxidant enzymes, glutathione (GSH), and catalase (CAT), as well as mRNA expression of TGF-β, MMP9, IL-1β, and TNF-α. Stained sections with haematoxylin and eosin (H & E) and Masson trichrome are used for histopathological evaluation and detection of fibrosis, respectively. Immunohistochemical staining for apoptosis (caspase-3), and autophagy (LC3) are also carried out. The combinations of SGLT2i and exercise exhibited the most significant cardioprotective effect. It improved diabetic-induced histopathological alterations in the myocardium and attenuated the elevation of serum blood glucose, CK-MB, LDH, myocardial MDA, and mRNA expression of TNF-α, IL-1β, TGF-β, MMP9, and the immune expression of caspase-3. Moreover, this combination increased the serum insulin, myocardial antioxidants GSH and CAT, and increase the immune expression of the LC-3. In conclusion, a combination of SGLT2i and exercise exerted a better antioxidant, anti-inflammatory, and antifibrotic effect in DCM. Moreover, the combination enhances the autophagic capacity of the heart.
Eldesoqui et al. (2022) studied Diabetic cardiomyopathy (n=30). Dapagliflozin and swimming (exercise) vs. Control, diabetes alone, diabetes + swimming alone, diabetes + dapagliflozin alone was evaluated on Cardioprotective effect (histopathological alterations, cardiac enzymes, oxidative stress, and inflammatory markers). The combination of dapagliflozin and exercise exerted significant cardioprotective, antioxidant, anti-inflammatory, and antifibrotic effects in a rat model of diabetic cardiomyopathy.
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