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Serum high-molecular-weight adiponectin and response to dapagliflozin in patients with type 2 diabetes and non-alcoholic fatty liver disease
  1. Yoshimasa Aso,
  2. Masaaki Sagara,
  3. Takafumi Niitani,
  4. Kanako Kato,
  5. Toshie Iijima,
  6. Takuya Tomaru,
  7. Teruo Jojima,
  8. Isao Usui
  1. Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
  1. Correspondence to Professor Yoshimasa Aso, Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi 321-0293, Japan; yaso{at}dokkyomed.ac.jp

Abstract

A better baseline renal function is associated with a better response to sodium-glucose co-transporter-2 inhibitors in patients with type 2 diabetes. Low serum adiponectin is associated with visceral fat accumulation and hepatic steatosis. We investigated the relationship between baseline serum adiponectin and glycemic response to dapagliflozin in patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). In a randomized, active-controlled, open-label trial, 57 patients with type 2 diabetes and NAFLD were randomized to either the dapagliflozin (5 mg/d) group or the control group. Both groups were treated for 24 weeks. Serum high-molecular-weight (HMW) adiponectin was measured with an ELISA kit. Visceral fat area (VFA) was measured by dual bioelectrical impedance analysis. Hepatic steatosis was assessed by the controlled attenuation parameter (CAP) measured by a transient elastography (FibroScan). Treatment with dapagliflozin significantly decreased HbA1c from 8.4%±1.5% at baseline to 7.4%±1.2% at 24 weeks. Both VFA and CAP decreased in the dapagliflozin group. Baseline serum HMW adiponectin was negatively correlated with changes in HbA1c from baseline to 24 weeks with dapagliflozin therapy. In the multivariate analysis, baseline HbA1c (β=−0.559, p=0.002) and serum HMW adiponectin (β=0.471, p=0.010) were independent determinants for the change (reduction) in HbA1c. In the dapagliflozin group, the change in HbA1c was positively correlated with the changes of CAP, but negatively correlated with the change in serum HMW adiponectin. In conclusion, a lower serum level of HMW adiponectin was associated with a better response to dapagliflozin in patients with type 2 diabetes and NAFLD.

Trial registration number

UMIN000022155.

  • diabetes complications
  • diabetes mellitus
  • drugs
  • investigational
  • adipokines

Data availability statement

Data are available in a public, open-access repository.

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Data availability statement

Data are available in a public, open-access repository.

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Footnotes

  • Contributors MS, TN, and KK contributed to the study design, data collection, and drafting of the manuscript. TI, TJ, and TT contributed to the discussion and reviewed the manuscript. IU reviewed/edited the manuscript. YA researched the data, and wrote and reviewed/edited the manuscript.

  • Funding This study was supported by Ono Pharmaceutical.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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