The Effect of SGLT2i on the GH/IGF1 Axis in Newly Diagnosed Male T2D Patients - A Prospective, Randomized Case-Control Study

Abstract

Abstract Purpose To investigate the effect of SGLT2i on the GH/IGF1 axis in male patients with newly diagnosed type 2 diabetes (T2D). Methods Sixty male patients with newly diagnosed T2D were recruited, randomly assigned to Metformine+SGLT2i group and Metformine group after baseline assessment. All patients received standard lifestyle interventions, blood indices were obtained before and after 12 weeks of treatment. Results After 12 weeks of Metformine+SGLT2i treatment, patients' FPG (Fasting plasma glucose), HBA1c, HOMA-IR, HOMA-β, and UACR were significantly improved (P<0.05). IGF1(P=0.01) and IGF1/IGFBP3 ratio (P<0.01) significantly increased, whereas GH, IGFBP3 did not change significantly. Metformine group reduced patients' FPG and HBA1c levels but did not affect IGF1, IGF1/IGFBP3 ratio, GH, IGFBP3 and HOMA-IR. Comparing Metformine+SGLT2i group and Metformine group, SGLT2i significantly improved HOMA-IR level [P=0.04], elevated IGF1/IGFBP3 ratio level [P=0.04], but had no significant effect on GH, IGF1 and IGFBP3. Correlation analysis showed that blood IGF1 level was negatively correlated with FPG, HBA1c, HOMA-IR, and positively correlated with IGFBP3. Regression analysis showed that FPG, testosterone had a negative effect on blood IGF1 level, and HOMAIR had no obvious effect on blood IGF1. Conclusion In male patients with newly diagnosed T2D, SGLT2i can increase IGF1/IGFBP3 ratio, alleviate insulin resistance, but it has no significant effect on GH and IGF1 levels. In addition, our study also showed that after Metformine+SGLT2i treatment, the blood IGF1 level increased, and insulin resistance improved, suggesting the positive role of IGF1 in newly diagnosed T2D.