Effect of sodium–glucose cotransporter 2 inhibitors on serum low‐density lipoprotein cholesterol in Japanese patients with type 2 diabetes mellitus

Abstract

ABSTRACTAims/IntroductionWe aimed to evaluate factors that influence changes in blood low‐density lipoprotein cholesterol (LDL‐C) levels after treatment with sodium–glucose cotransporter 2 (SGLT2) inhibitors in Japanese patients with type 2 diabetes.Materials and MethodsWe retrospectively analyzed clinical data of outpatients newly initiated on SGLT2 inhibitors (n = 176) and other oral antidiabetic drugs (n = 227). The patients were classified into four subgroups according to statin administration and baseline LDL‐C levels (<120 or ≥120 mg/dL). Clinical characteristics were compared among the subgroups. Multivariate analysis was carried out to identify factors contributing to changes in LDL‐C.ResultsThe median follow‐up period was 13.0 weeks (range 11.9–14.1 weeks, min 8 weeks, maximum 16 weeks) in the SGLT2i group, and 12.0 weeks (range 10.0–14.0 weeks, min 8 weeks, maximum 16 weeks) in the control group. Both groups showed a significant decrease in LDL‐C (SGLT2i group −3.8 ± 24.7 mg/dL, control group −3.4 ± 15.0 mg/dL). Multivariate regression analyses showed that in both groups, the change in LDL‐C depended on statin use and baseline LDL‐C levels. Stratified analyses showed that LDL‐C level was significantly decreased in statin users with baseline LDL‐C ≥120 mg/dL (from 148.9 ± 33.5 to 109.3 ± 17.9 mg/dL, P = 0.002), and significantly increased in statin non‐users with baseline LDL‐C <120 mg/dL (from 96.3 ± 27.3 to 104.7 ± 24.8 mg/dL, P = 0.002). These changes were more characteristic for SGLT2 inhibitors than for other oral antidiabetic drugs (P for interaction = 0.010 and <0.001, respectively).ConclusionsLDL‐C levels and statin medication at baseline influence changes in LDL‐C after SGLT2 inhibitors treatment in Japanese patients with type 2 diabetes.