ACTIV-3/TICO Study Group* Background: Ensovibep (MP0420) is a designed ankyrin repeat protein, a novel class of engineered proteins, under investigation as a treatment of SARS-CoV-2 infection.Objective: To investigate if ensovibep, in addition to remdesivir and other standard care, improves clinical outcomes among patients hospitalized with COVID-19 compared with standard care alone.
Background. Cardiovascular morbidity increases notably among patients with diabetes. A correlation between leptin resistance and cardiovascular risk was found in patients with arterial hypertension and metabolic syndrome. However, there are no data about the influence of empagliflozin on leptin level; empagliflozin effectiveness against key cardiovascular risk factors in diabetic patients with normal weight and overweight has not been studied yet. The purpose of this work was to study the impact of comprehensive treatment using metformin and empagliflozin on the main cardiovascular risk factors in patients with type 2 diabetes mellitus with different body weights. Materials and methods. Ninety-seven patients with type 2 diabetes with normal weight, overweight and obesity were examined. Anthropometric indicators were taken. The parameters of carbohydrate and lipid metabolism, the level of leptin in blood serum were determined and the HOMA-IR was calculated. Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r = 0.505, p < 0.05; r = 0.846, p < 0.05; r = 0.886, p < 0.05 in patients of groups I–III). After a 6-month course of treatment with metformin and empagliflozin, body weight and waist circumference significantly decreased in overweight and obese patients, and no significant changes between groups were found in those with a normal body mass index. A reliable positive effect of comprehensive treatment on indicators of carbohydrate metabolism, systolic blood pressure, regardless of the patient’s weight, was noted. Under the influence of comprehensive treatment with the use of empagliflozin, the level of leptin (p < 0.05) and HOMA-IR (p < 0.05) also decreased significantly in patients of all groups, regardless of body mass index. Conclusions. It was found that the combined use of metformin and empagliflozin for 6 months had a reliable effect on the modified cardiovascular risk factors in patients with type 2 diabetes of different weights.
The objective of this study was to investigate the effect of empagliflozin on insulin resistance, leptin and proinflammatory cytokine levels in patients with type 2 diabetes.
Materials and methods. 100 patients with type 2 diabetes with normal weight, overweight and obesity of various degrees were examined. Anthropometric indicators were taken. Levels of leptin, IL-6, CRP in blood serum were determined, HOMA index was calculated.
Results. Insulin resistance in all groups of patients was associated with abdominal obesity, hyperleptinemia (r = 0.505, p < 0.05), (r = 0.846, p < 0.05), (r = 0.886, p < 0.05), (r = 0.736, p < 0.05) in patients from Group I-IV. Patients of all examined groups have shown a significant increase in IL-6 levels, compared with the control group (p < 0.05), but the level of IL-6 in patients from Group II, III and IV have been significantly higher than those from Group I (p < 0.05) and the control group (p < 0.05) and has increased along with the weight gain. Similarly, the highest indices of CRP levels have been found in patients from Group IV which proves a high pro-inflammatory activity in these patients with type 2 diabetes and obesity. After a 6-month course of treatment patients taking empagliflozin, regardless of BMI, have shown significantly decreased levels of both IL-6 (p < 0.05), and CRP (p < 0.05). Levels of leptin (p < 0.05) and HOMA index (p < 0.05) were significantly reduced in obese patients, too.
Conclusions. As a result of the study, it has been established that the use of empagliflozin in the dose of 10 mg per day for 6 months has had a significant effect on anthropometric parameters and markers of insulin resistance (HOMA index, leptin) in patients with type 2 diabetes and obesity. A significant decrease in the levels of IL-6 and CRP under the influence of empagliflozin, regardless of the patient’s weight has been revealed.
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