Current possibilities of influencing the main cardiovascular risk factors in patients with type 2 diabetes mellitus

Abstract

Background. Cardiovascular morbidity increases notably among patients with diabetes. A correlation between leptin resistance and cardiovascular risk was found in patients with arterial hypertension and metabolic syndrome. However, there are no data about the influence of empagliflozin on leptin level; empagliflozin effectiveness against key cardiovascular risk factors in diabetic patients with normal weight and overweight has not been studied yet. The purpose of this work was to study the impact of comprehensive treatment using metformin and empagliflozin on the main cardiovascular risk factors in patients with type 2 diabetes mellitus with different body weights. Materials and methods. Ninety-seven patients with type 2 diabetes with normal weight, overweight and obesity were examined. Anthropometric indicators were taken. The parameters of carbohydrate and lipid metabolism, the level of leptin in blood serum were determined and the HOMA-IR was calculated. Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r=0.505, p<0.05; r=0.846, p<0.05; r=0.886, p<0.05 in patients of groups I–III). After a 6-month course of treatment with metformin and empagliflozin, body weight and waist circumference significantly decreased in overweight and obese patients, and no significant changes between groups were found in those with a normal body mass index. A reliable positive effect of comprehensive treatment on indicators of carbohydrate metabolism, systolic blood pressure, regardless of the patient’s weight, was noted. Under the influence of comprehensive treatment with the use of empagliflozin, the level of leptin (p<0.05) and HOMA-IR (p<0.05) also decreased significantly in patients of all groups, regardless of body mass index. Conclusions. It was found that the combined use of metformin and empagliflozin for 6 months had a reliable effect on the modified cardiovascular risk factors in patients with type 2 diabetes of different weights.