Inhibition of sodium glucose cotransporter 2 with empagliflozin results in caloric loss by increasing urinary glucose excretion and has a mild diuretic effect. Diuretic effects are usually associated with reflex-mediated increases in sympathetic tone, whereas caloric loss is associated with decreased sympathetic tone. In an open-label trial, muscle sympathetic nerve activity (MSNA) (burst frequency, burst incidence, and total MSNA) was assessed using microneurography performed off-treatment and on day 4 of treatment with empagliflozin 25 mg once daily in 22 metformin-treated patients with type II diabetes (mean [range] age 54 [40-65] years). Systolic and diastolic blood pressure (BP), heart rate, urine volume, and body weight were assessed before and on day 4 (BP, heart rate), day 5 (urine volume), or day 6 (body weight) of treatment with empagliflozin. After 4 days of treatment with empagliflozin, no significant changes in MSNA were apparent despite a numerical increase in urine volume, numerical reductions in BP, and significant weight loss. There were no clinically relevant changes in heart rate. Empagliflozin is not associated with clinically relevant reflex-mediated sympathetic activation in contrast to increases observed with diuretics in other studies. Our study suggests a novel mechanism through which sodium glucose cotransporter 2 inhibition affects human autonomic cardiovascular regulation.

中文翻译：

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Empagliflozin对II型糖尿病患者肌肉交感神经活动的影响。

依帕列净抑制钠葡萄糖共转运蛋白2会通过增加尿中葡萄糖的排泄而导致热量损失，并具有轻度的利尿作用。利尿作用通常与反射介导的交感神经调高相关，而热量减少与交感神经调低有关。在一项开放标签试验中，使用微神经​​造影术评估了肌肉交感神经活性（MSNA）（爆发频率，爆发发生率和总MSNA），并在22天二甲双胍治疗后第4天每天使用恩格列净25 mg一次II型糖尿病患者（平均[年龄] 54岁[40-65]岁）。在第4天（血压，心率），第5天（尿量）之前和第4天评估收缩压和舒张压（BP），心率，尿量和体重，或依帕列净治疗的第6天（体重）。用恩帕格列净治疗4天后，尽管尿量有所增加，血压有所下降和体重减轻，但MSNA并未出现明显变化。心率无临床相关变化。Empagliflozin与临床相关的反射介导的交感神经激活无关，相反，在其他研究中，利尿剂引起的交感神经激活却有所增加。我们的研究提出了一种新机制，通过该机制，钠葡萄糖共转运蛋白2的抑制作用会影响人类自主性心血管调节。心率无临床相关变化。Empagliflozin与临床相关的反射介导的交感神经激活无关，相反，在其他研究中，利尿剂引起的交感神经激活却有所增加。我们的研究提出了一种新的机制，通过该机制，钠葡萄糖共转运蛋白2的抑制作用会影响人类自主的心血管调节。心率无临床相关变化。Empagliflozin与临床相关的反射介导的交感神经激活无关，相反，在其他研究中，利尿剂引起的交感神经激活却有所增加。我们的研究提出了一种新的机制，通过该机制，钠葡萄糖共转运蛋白2的抑制作用会影响人类自主的心血管调节。