Effects of Empagliflozin on Carotid Intima-Media Thickness and Epicardial Fat Tissue Volume in Patients with Type-2 Diabetes Mellitus

Introduction: Changes in epicardial adipose tissue (EAT) and carotid intima-media thickness (CIMT), which are markers of subclinical atherosclerosis, were investigated in patients with type-2 diabetes mellitus (DM) initiated with empagliflozin.
Methods: Thirty-seven patients with type-2 DM were included in this study. Empagliflozin was administered to all patients within the indication, and EAT and CIMT measurements were performed. After an average of 6 months of treatment, the effects of empagliflozin on EAT and CIMT were evaluated through remeasurements.
Results: The mean age of the study group was 56.95±11.61 years, and 56.8% (n=21) of the participants were women. The mean duration of DM was 8.6±3.3 years. Significant reductions were found in weight, waist circumference, body mass index, and systolic and diastolic blood pressure at the treatment initiation and post-treatment evaluation (p<0.001 for each). Significant reductions in EAT and CIMT were noted with empagliflozin treatment (7.6±1.7 vs. 6.7±1.3, p<0.001 and 9.0±2.2 vs. 7.7±1.4, p=0.001, respectively).
Discussion and Conclusion: Treatment with empagliflozin may improve systemic metabolic parameters and decrease the EAT volume and CIMT in patients with type-2 DM. This could result in a reduced risk of cardiovascular events.

Keywords: Empagliflozin; Epicardial adipose tissue; Carotid intima-media thickness; Type-2 diabetes mellitus