A Vanderbilt University study reveals that the diabetes medication empagliflozin may offer cardiovascular protective effects by calming inflammatory immune responses in women with obesity and prediabetes, highlighting a new anti-inflammatory role beyond blood sugar control.
A common class of diabetes medicines may do more than lower blood sugar. In a human pilot trial reported in Circulation, researchers at Vanderbilt University Medical Centre found that the SGLT2 inhibitor empagliflozin reduced a blood signal tied to inflammation and cardiovascular disease in women with obesity and prediabetes. The findings add to a growing body of work suggesting these drugs may protect the heart partly by calming inflammatory pathways, not just by improving glucose control or helping with weight loss.
The study followed 16 women for three months and compared their immune changes with those seen in a separate group that followed a low-calorie diet. Using genetic sequencing and cellular imaging, the investigators focused on monocyte-platelet aggregates, or MPAs, which form when platelets stick to monocytes, a type of immune cell. These clusters are thought to contribute to vascular inflammation and heart disease. The research team said the aggregates fell within two weeks of treatment and continued to decline by the end of the study, while the diet group did not show the same change.
The scientists also reported that monocytes appeared to undergo metabolic reprogramming, shifting away from a highly inflammatory state towards a more stable energy profile. Mona Mashayekhi, a Vanderbilt diabetes specialist involved in the work, said the result is the first direct human evidence that SGLT2 inhibitors can alter immune cells in a targeted way. She said the finding could help identify which patients are most likely to benefit from the drugs and may point to other therapeutic targets in the same pathway.
The new trial fits with earlier experimental work. Reviews and meta-analyses published before this study had suggested SGLT2 inhibitors may reduce inflammatory markers in animal models and influence immune activity in people with type 2 diabetes, including effects on macrophages and inflammatory signalling. A review in Nature Reviews Cardiology also argued that anti-inflammatory effects could help explain part of the drugs’ cardiovascular benefit. The Vanderbilt team has now started a larger randomised placebo-controlled study in 74 participants with obesity and metabolic syndrome, this time adding analysis of fat tissue to examine how the medicines affect obesity-related inflammation more broadly.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
