Abstract Background Coronary heart disease (CHD) is a leading cause of death among patients with glucose metabolism disorders. Previous studies have demonstrated that sodium-dependent glucose transporter 2 inhibitors (SGLT2i) offer cardiovascular benefits in diabetes patients at high cardiovascular risk. However, the effect of SGLT2i on triglyceride-derived indices among them remains unclear. Methods This prospective study analyzed data from 550 CHD patients from August 2020 to August 2021. Among those patients, 223 received SGLT2i, and 327 did not. Patients were categorized into three groups by diabetes control status based on fasting blood glucose (FBG) levels during hospitalization: well-controlled diabetes (FBG 6.1 mmol/L), moderately controlled diabetes (FBG between 6.1 mmol/L to 7.0 mmol/L) and poorly controlled diabetes (FBG 7.0 mmol/L). Baseline demographic data and biochemical indices, including plasma lipid profiles and remnant cholesterol and triglyceride (TG)-derived metabolic indicators were collected. The TG-derived metabolic indicators includes the atherogenic index of plasma (AIP) and the triglyceride-glucose (TyG) index. The AIP and TyG were calculated via the following formulas: AIP: Lg TG (mg/dl)/HDL (mg/dl), TyG: Ln TG (mg/dL) × FPG (mg/dL)/2. Multiple linear regression, logistic regression, subgroup analysis and sensitivity analysis were adopted to reveal the associations among biochemical indicators, SGLT2i and diabetes control status. Results The study included 550 CHD patients with an average age of 60.2 years, 21.8% of whom were female. Multiple linear regression indicated a significant positive effect of SGLT2i on changing AIP (β=-0.052, 95% CI, -0.096 to -0.009, P=0.018) and TG levels (β=-0.089, 95% CI, -0.177 to -0.004, P=0.039). The interaction between SGLT2i use and diabetes control status was statistically significant for AIP changes (P for interaction = 0.041), with greater benefits observed in patients with poorly controlled diabetes (β=-0.080, 95% CI, -0.138 to -0.023, P=0.007). Logistic regression revealed higher SGLT2i prescription rates linked to significant AIP reduction (Q1 vs Q4: odds ratio, 1.887, 95% CI, 1.149 to 3.100, P=0.012; P for trend = 0.035). Sensitivity analysis confirmed these findings in patients with hypertension and high BMI. Conclusions SGLT2i improved the AIP and TG levels in CHD patients with diabetes, regardless of background hypoglycemic and lipid-lowering drugs. Moreover, patients with poorly controlled diabetes might benefit more from SGLT2i treatment.Figure 1-6 Table 1&2
Yin et al. (2025) studied this question.