Dapagliflozin and xanthine oxidase inhibitors improve insulin resistance and modulate renal glucose and urate transport in metabolic syndrome

Author(s):  
Hwee‐Yeong Ng ◽  
Foong‐Fah Leung ◽  
Wei‐Hung Kuo ◽  
Wen‐Chin Lee ◽  
Chien‐Te Lee
2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Hwee-Yeong Ng ◽  
Chien-Te Lee ◽  
Foong-Fah Leung ◽  
Yuai-Ting Lee

Abstract Background and Aims Metabolic syndrome consists of several medical conditions that collectively predict the risk for cardiovascular disease. Hyperglycemia and hyperuricemia are the major disorders of metabolic syndrome. Kidney reabsorbs almost all filtrated glucose by active transport at normal concentrations of plasma glucose via members of the sodium glucose transport (SGLT) family. Besides, the kidney plays a pivotal role in handling uric acid homeostasis. Uric acid is mainly controlled by urate transporter (UAT), urate anion exchanger 1 (URAT1) and glucose transporter 9 (GLUT9). The aims of the study were to determine the alteration of renal glucose and uric acid transporters in animals with metabolic syndrome after treatment of xanthine oxidase inhibitors and SGLT2 inhibitor. Method Sprague-Dawley rats were fed with normal chow (Control) or high fructose diet (60%) for totally 6 months. For those animals fed with high fructose diet for 3 months, they were divided into 4 groups including high fructose diet without treatment (FR), treatment with allopurinol (150 mg/L in drinking water), with febuxostat (30 mg/L in drinking water) or with dapagliflozin (1mg/kg/day intraperitoneal injection). Blood, urine and blood pressure were collected and measured at the end of study. Gene and protein expression of renal glucose and uric acid transporters were determined by reverse transcriptase polymerase chain reaction. The changes of transporters were then confirmed by immunohistochemical staining. Results High-fructose diet induced higher levels of fasting glucose, insulin resistance index, uric acid, triglyceride and blood pressure in FR group (all p <0.05 vs. control). Treatment of allopurinol, febuxostat and dapagliflozin reduced body weight significantly. Fasting glucose, insulin resistance index and hyperuricemia were improved in all drug treatment groups (all p <0.05). In the kidney, high fructose diet significantly upregulated SGLT1, SGLT2 and GLUT2 but downregulated GLUT1 expression. Urate transporters, including GLUT9, UAT and URAT1 were also increased (p <0.05). The improvement of insulin resistance by xanthine oxidase inhibitors was associated with suppression of renal SGLT1, SGLT2 and GLUT2 expression. Dapagliflozin alleviated hyperuricemia and induced uricosuria without affecting serum xanthine oxidase activity. Compared to FR, dapagliflozin significantly inhibited fructose-induced overexpression of GLUT9, UAT and URAT1 in the kidney. Conclusion Long term high fructose diet induced metabolic syndrome in rats. Treatment of xanthine oxidase inhibitors and dapagliflozin ameliorated components of metabolic syndrome. Both allopurinol and febuxostat improved insulin resistance in association with suppression of renal SGLT1, SGLT2 and GLUT2 expression. Although dapagliflozin and xanthine oxidase inhibitors reduced uric acid in different mechanisms, they shared a similar molecular changes in the kidney by downregulating GLUT9, UAT and URAT1 expression.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 388-388
Author(s):  
Dustin Davis ◽  
Hal Scofield ◽  
Nancy Betts ◽  
Kenneth Izuora ◽  
Arpita Basu

Abstract Objectives Dietary berries have been shown to lower cardio-metabolic risks in clinical trials. We examined the dose-response effects of two dietary achievable doses of strawberries on low-density lipoprotein cholesterol (LDL-C) and insulin resistance in adults with metabolic syndrome. Methods In this 14-week randomized controlled crossover study, adults with metabolic syndrome were assigned to one of the three arms for 4 weeks separated by a one-week washout period: control powder, one serving strawberries (13 g powder/day), and 2.5 servings strawberries (32 g powder/day). The freeze-dried powders were blended in water, and participants consumed half the daily dose in the morning and half in the evening. Participants were instructed to follow their usual diet and lifestyle while refraining from consuming other berries and related products throughout the study. Results Thirty participants completed all three phases of the trial (baseline profiles: weight: 90.8 ± 22.4 kg, BMI: 33.1 ± 4.2 kg/m2, waist circumference: 109 ± 12.5 cm, HbA1c : 5.8 ± 0.2%). Outcome measures were analyzed using a multivariate analysis of variance with statistical significance set at P < 0.05. Preliminary data indicate a significant reduction in the homeostatic model of assessment of insulin resistance (HOMA-IR) following the 2.5 servings strawberries when compared to the 1 serving strawberry and control phases. Glucose and conventional lipid profiles did not differ among groups. Small LDL particle concentration (nuclear magnetic resonance-determined) was significantly decreased in the high dose strawberry group compared to baseline and one-serving group (P < 0.05). Conclusions These data suggest that consuming strawberries at 2.5 servings daily for four weeks significantly improved insulin resistance and LDL particle profile in adults with metabolic syndrome. Funding Sources Supported by the California Strawberry Commission.


2010 ◽  
Vol 17 (3-4) ◽  
pp. 189-193 ◽  
Author(s):  
Thomas C. Wascher ◽  
Jan H. N. Lindeman ◽  
Harald Sourij ◽  
Teake Kooistra ◽  
Giovanni Pacini ◽  
...  

2009 ◽  
Vol 6 (4) ◽  
pp. 3-8
Author(s):  
M A Berkovskaya ◽  
S A Butrova

The review article highlights the main effects of therapeutic strategies on proinflammatory and procoagulant abnormalities which accompany metabolic syndrome. The main role in correction of these abnormalities belongs to dietotherapy and physical exercises. Besides, sometimes it is appropriate to use drugs which improve insulin resistance - metformin and thiazolidinediones - as they display many other positive effects, such as anti-inflammatory and anticoagulant actions.


2010 ◽  
Vol 104 (12) ◽  
pp. 1868-1877 ◽  
Author(s):  
Takahiko Fujikawa ◽  
Tetsuya Hirata ◽  
Atsunori Wada ◽  
Naomi Kawamura ◽  
Yasuyo Yamaguchi ◽  
...  

Eucommia bark (Eucommia ulmoides Oliver) has been used as an herbal medicine, and more recently, the plant's leaves have been widely used to prepare tea which may have anti-obesity properties. We used a metabolic syndrome-like rat model, produced by feeding a 35 % high-fat diet (HFD), to examine potential anti-obesity and anti-metabolic syndrome effects and mechanisms of chronic administration of Eucommia leaf as an extract or green leaf powder. Eighty rats were studied for 3 months in ten groups. Both forms of Eucommia leaves minimised increases in body weight and visceral fat in a dose-dependent fashion. Increases in plasma levels of TAG and NEFA, and insulin resistance secondary to HFD were lessened by both forms of Eucommia leaf. Concomitantly, an increase in plasma adiponectin levels and suppression of plasma resistin and TNF-α levels were confirmed. Real-time PCR studies showed that both forms of Eucommia leaf enhanced metabolic function across several organs, including diminishing ATP production (white adipose tissue), accelerating β-oxidation (liver) and increasing the use of ketone bodies/glucose (skeletal muscle), all of which may exert anti-obesity effects under HFD conditions. These findings suggest that chronic administration of either form of Eucommia leaves stimulates the metabolic function in rats across several organs. The anti-obesity and anti-metabolic syndrome activity in this rat model may be maintained through secretion and regulation of adipocytokines that depend on the accumulation of visceral fat to improve insulin resistance or hyperlipaemia.


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