TY - JOUR
T1 - The effects of semaglutide, empagliflozin and their combination on the kidney sodium signal from magnetic resonance imaging
T2 - A prespecified, secondary analysis from a randomized, clinical trial
AU - Gullaksen, Søren
AU - Vernstrøm, Liv
AU - Sørensen, Steffen S
AU - Ringgaard, Steffen
AU - Laustsen, Christoffer
AU - Birn, Henrik
AU - Funck, Kristian L
AU - Poulsen, Per L
AU - Laugesen, Esben
N1 - Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2024/2
Y1 - 2024/2
N2 - AIMS: To evaluate the effect of treatment with semaglutide and empagliflozin on the cortico-medullary sodium gradient (MCR; medulla/cortex ratio), urine sodium/creatinine ratio (UNACR), and estimated plasma volume (ePV) and to compare the MCR between persons with and without type 2 diabetes.METHODS: Using the
23Na magnetic resonance imaging (
23Na-MRI) technique, we investigated the effects of 32 weeks of treatment with semaglutide, empagliflozin or their combination on MCR in 65 participants with type 2 diabetes and high risk of cardiovascular disease. The participants were recruited from a randomized, controlled interventional trial and further characterized by UNACR and ePV. In addition, in a cross-sectional design, we compared MCR by
23Na-MRI in 12 persons with type 2 diabetes and 17 matched controls. Data from the interventional trial were analyzed using a single, multivariate linear mixed model strategy for repeated measurements. Data from the cross-sectional study were analyzed by fitting a linear regression model adjusted for age and sex.
RESULTS: Compared to placebo, semaglutide, but not empagliflozin, significantly decreased the MCR (-9 %, 95%CI (-18, -0.06)%, p = 0.035 and -0.05 %, 95%CI(-0.15, 0.05)%, p = 0.319, respectively). The UNACR decreased in the semaglutide group(-35 %, 95 % CI(-52, -14) %, p = 0.003) but not in the empagliflozin group (7 %, 95 % CI(-21, 44)%, p = 0.657), whereas the ePV decreased in the combination group. The MCR was not different between persons with and without type 2 diabetes.CONCLUSION:
23Na magnetic resonance imaging can identify drug induced changes in the MCR in persons with type 2 diabetes, and 32 weeks of semaglutide decreases the MCR in such persons. There is no difference in the MCR between persons with and without type 2 diabetes.
TRIAL NUMBER AND REGISTRY: EUDRACT 2019-000781-38, clinicaltrialsregister.eu.
AB - AIMS: To evaluate the effect of treatment with semaglutide and empagliflozin on the cortico-medullary sodium gradient (MCR; medulla/cortex ratio), urine sodium/creatinine ratio (UNACR), and estimated plasma volume (ePV) and to compare the MCR between persons with and without type 2 diabetes.METHODS: Using the
23Na magnetic resonance imaging (
23Na-MRI) technique, we investigated the effects of 32 weeks of treatment with semaglutide, empagliflozin or their combination on MCR in 65 participants with type 2 diabetes and high risk of cardiovascular disease. The participants were recruited from a randomized, controlled interventional trial and further characterized by UNACR and ePV. In addition, in a cross-sectional design, we compared MCR by
23Na-MRI in 12 persons with type 2 diabetes and 17 matched controls. Data from the interventional trial were analyzed using a single, multivariate linear mixed model strategy for repeated measurements. Data from the cross-sectional study were analyzed by fitting a linear regression model adjusted for age and sex.
RESULTS: Compared to placebo, semaglutide, but not empagliflozin, significantly decreased the MCR (-9 %, 95%CI (-18, -0.06)%, p = 0.035 and -0.05 %, 95%CI(-0.15, 0.05)%, p = 0.319, respectively). The UNACR decreased in the semaglutide group(-35 %, 95 % CI(-52, -14) %, p = 0.003) but not in the empagliflozin group (7 %, 95 % CI(-21, 44)%, p = 0.657), whereas the ePV decreased in the combination group. The MCR was not different between persons with and without type 2 diabetes.CONCLUSION:
23Na magnetic resonance imaging can identify drug induced changes in the MCR in persons with type 2 diabetes, and 32 weeks of semaglutide decreases the MCR in such persons. There is no difference in the MCR between persons with and without type 2 diabetes.
TRIAL NUMBER AND REGISTRY: EUDRACT 2019-000781-38, clinicaltrialsregister.eu.
KW - Benzhydryl Compounds
KW - Cross-Sectional Studies
KW - Diabetes Mellitus, Type 2/complications
KW - Glucagon-Like Peptides
KW - Glucosides
KW - Humans
KW - Hypoglycemic Agents/therapeutic use
KW - Kidney
KW - Magnetic Resonance Imaging
KW - Magnetic Resonance Spectroscopy
UR - http://www.scopus.com/inward/record.url?scp=85182873030&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2023.108673
DO - 10.1016/j.jdiacomp.2023.108673
M3 - Journal article
C2 - 38219335
SN - 1056-8727
VL - 38
SP - 108673
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
IS - 2
M1 - 108673
ER -