The changes of oxidative stress markers and vitamin E in patients with diabetes using SGLT2 inhibitors

INTRODUCTION: This study aimed to research the diversities of vitamin E and oxidative stress parameters related to sodiumglucose transport protein 2 (SGLT2) inhibitor use by type 2 diabetes mellitus (T2DM) patients.
METHODS: This observational clinical study collected data from 67 T2DM patients (55.7±9.3 years, 46% female). Vitamin E, total oxidant status (TOS), total antioxidant status (TAS), total thiol, native thiol, myeloperoxidase, and catalase levels were evaluated. The TOS/TAS ratio was calculated as the oxidative stress index. Correlations of the parameters to each other and differences based on SGLT2 inhibitor use were recorded.
RESULTS: The mean hemoglobin A1c was 7.1 (5.5–13.1). SGLT2 inhibitors (all combinations) were used by 25 patients (37.3%). The mean level of vitamin E was 6 (3.6–9.8) mg/L. There was a positive correlation between vitamin E and low-density lipoprotein cholesterol (p<0.001). While there was no significant correlation between vitamin E and all included oxidative stress parameters, the level of vitamin E was statistically lower in patients using pioglitazone (p=0.036) and statins (p<0.001). In patients using SGLT2 inhibitors, fasting glucose, triglycerides, alanine aminotransferase, and the spot urine protein/creatinine ratio were significantly lower, and the mean TAS was higher (p<0.05).
DISCUSSION AND CONCLUSION: While no differences were observed in vitamin E and other oxidative parameters related to SGLT2 inhibitor use, the increase in TAS provides motivation for further research investigating the antioxidant properties of these inhibitors.