TY - JOUR
T1 - Effects of dapagliflozin and dapagliflozin-saxagliptin on erythropoiesis, iron and inflammation markers in patients with type 2 diabetes and chronic kidney disease
T2 - data from the DELIGHT trial
AU - Koshino, Akihiko
AU - Neuen, Brendon L.
AU - Jongs, Niels
AU - Pollock, Carol
AU - Greasley, Peter J.
AU - Andersson, Eva Marie
AU - Hammarstedt, Ann
AU - Karlsson, Cecilia
AU - Langkilde, Anna Maria
AU - Wada, Takashi
AU - Heerspink, Hiddo J.L.
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: This post-hoc analysis of the DELIGHT trial assessed effects of the SGLT2 inhibitor dapagliflozin on iron metabolism and markers of inflammation. Methods: Patients with type 2 diabetes and albuminuria were randomized to dapagliflozin, dapagliflozin and saxagliptin, or placebo. We measured hemoglobin, iron markers (serum iron, transferrin saturation, and ferritin), plasma erythropoietin, and inflammatory markers (urinary MCP-1 and urinary/serum IL-6) at baseline and week 24. Results: 360/461 (78.1%) participants had available biosamples. Dapagliflozin and dapagliflozin-saxagliptin, compared to placebo, increased hemoglobin by 5.7 g/L (95%CI 4.0, 7.3; p < 0.001) and 4.4 g/L (2.7, 6.0; p < 0.001) and reduced ferritin by 18.6% (8.7, 27.5; p < 0.001) and 18.4% (8.7, 27.1; p < 0.001), respectively. Dapagliflozin reduced urinary MCP-1/Cr by 29.0% (14.6, 41.0; p < 0.001) and urinary IL-6/Cr by 26.6% (9.1, 40.7; p = 0.005) with no changes in other markers. Conclusions: Dapagliflozin increased hemoglobin and reduced ferritin and urinary markers of inflammation, suggesting potentially important effects on iron metabolism and inflammation. Trial registration: ClinicalTrials.gov NCT02547935.
AB - Background: This post-hoc analysis of the DELIGHT trial assessed effects of the SGLT2 inhibitor dapagliflozin on iron metabolism and markers of inflammation. Methods: Patients with type 2 diabetes and albuminuria were randomized to dapagliflozin, dapagliflozin and saxagliptin, or placebo. We measured hemoglobin, iron markers (serum iron, transferrin saturation, and ferritin), plasma erythropoietin, and inflammatory markers (urinary MCP-1 and urinary/serum IL-6) at baseline and week 24. Results: 360/461 (78.1%) participants had available biosamples. Dapagliflozin and dapagliflozin-saxagliptin, compared to placebo, increased hemoglobin by 5.7 g/L (95%CI 4.0, 7.3; p < 0.001) and 4.4 g/L (2.7, 6.0; p < 0.001) and reduced ferritin by 18.6% (8.7, 27.5; p < 0.001) and 18.4% (8.7, 27.1; p < 0.001), respectively. Dapagliflozin reduced urinary MCP-1/Cr by 29.0% (14.6, 41.0; p < 0.001) and urinary IL-6/Cr by 26.6% (9.1, 40.7; p = 0.005) with no changes in other markers. Conclusions: Dapagliflozin increased hemoglobin and reduced ferritin and urinary markers of inflammation, suggesting potentially important effects on iron metabolism and inflammation. Trial registration: ClinicalTrials.gov NCT02547935.
KW - Anemia
KW - Ferritin
KW - Hematopoiesis
KW - Interleukin-6
KW - Iron metabolism
KW - Monocyte chemoattractant protein-1
KW - Sodium glucose co-transporter 2 inhibitors
KW - Transferrin
UR - http://www.scopus.com/inward/record.url?scp=85178234095&partnerID=8YFLogxK
U2 - 10.1186/s12933-023-02027-8
DO - 10.1186/s12933-023-02027-8
M3 - Article
C2 - 38017482
AN - SCOPUS:85178234095
SN - 1475-2840
VL - 22
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 330
ER -