Sodium-glucose co-transporter-2 inhibitors suppress atrial natriuretic peptide secretion in patients with newly diagnosed Type 2 diabetes

Diabet Med. 2016 Dec;33(12):1732-1736. doi: 10.1111/dme.13107. Epub 2016 May 26.

Abstract

Aims: To observe changes in atrial natriuretic peptide levels after treatment with sodium-glucose co-transporter-2 inhibitors in patients with newly diagnosed type 2 diabetes.

Methods: A total of 28 patients with newly diagnosed Type 2 diabetes and HbA1c levels of 58 -91 mmol/mol (7.5-10.5%) were randomly selected to receive sodium-glucose co-transporter-2 inhibitor treatment (n = 18) or placebo (n = 10) for 24 weeks. We analysed atrial natriuretic peptide concentrations, using an enzyme-linked immunosorbent assay. In addition, sodium and HbA1c levels were measured at baseline, 12 weeks and 24 weeks and blood lipid levels and insulin sensitivities at baseline and 24 weeks.

Results: Compared with patients treated with placebo, patients who received sodium-glucose co-transporter-2 inhibitor treatment exhibited lower atrial natriuretic peptide levels (36.74 vs 56.90 pg/ml in the placebo group; P < 0.05) and higher sodium levels (144.3 vs 141.4 mmol/l in the placebo group; P < 0.01) at 24 weeks, after adjusting for baseline values. HbA1c levels were lower after sodium-glucose co-transporter-2 inhibitor treatment compared with placebo (51 vs 60 mmol/mol; P < 0.01). No correlation was found between atrial natriuretic peptide and HbA1c levels. Homeostatic model assessment of β-cell function values and lipid profiles were generally similar after 24 weeks of treatment with placebo or sodium-glucose co-transporter-2 inhibitor.

Conclusions: This study shows the ability of sodium-glucose co-transporter-2 inhibitors to lower atrial natriuretic peptide levels and improve glycaemic control, which may benefit the cardiovascular system.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Atrial Natriuretic Factor / metabolism*
  • Benzhydryl Compounds / therapeutic use*
  • Blood Glucose / metabolism
  • Cholesterol, LDL / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Glucosides / therapeutic use*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Insulin-Secreting Cells / physiology
  • Male
  • Middle Aged
  • Sodium-Glucose Transport Proteins / therapeutic use*
  • Sodium-Glucose Transporter 2 Inhibitors

Substances

  • Benzhydryl Compounds
  • Blood Glucose
  • Cholesterol, LDL
  • Glucosides
  • Glycated Hemoglobin A
  • Sodium-Glucose Transport Proteins
  • Sodium-Glucose Transporter 2 Inhibitors
  • dapagliflozin
  • Atrial Natriuretic Factor