Acute effects of empagliflozin on open-loop baroreflex function and urine output in streptozotocin-induced type 1 diabetic rats

J Physiol Sci. 2024 Sep 28;74(1):48. doi: 10.1186/s12576-024-00938-z.

Abstract

Although sympathetic suppression is considered one of the mechanisms for cardioprotection afforded by sodium-glucose cotransporter 2 (SGLT2) inhibitors, whether SGLT2 inhibition acutely modifies sympathetic arterial pressure (AP) regulation remains unclear. We examined the acute effect of an SGLT2 inhibitor, empagliflozin (10 mg/kg), on open-loop baroreflex static characteristics in streptozotocin (STZ)-induced type 1 diabetic and control (CNT) rats (n = 9 each). Empagliflozin significantly increased urine flow [CNT: 25.5 (21.7-31.2) vs. 55.9 (51.0-64.5), STZ: 83.4 (53.7-91.7) vs. 121.2 (57.0-136.0) μL·min-1·kg-1, median (1st-3rd quartiles), P < 0.001 for empagliflozin and STZ]. Empagliflozin decreased the minimum sympathetic nerve activity (SNA) [CNT: 15.7 (6.8-18.4) vs. 10.5 (2.9-19.0), STZ: 36.9 (25.7-54.9) vs. 32.8 (15.1-37.5) %, P = 0.021 for empagliflozin and P = 0.003 for STZ], but did not significantly affect the peripheral arc characteristics assessed by the SNA-AP relationship. Despite the significant increase in urine flow and changes in several baroreflex parameters, empagliflozin preserved the overall sympathetic AP regulation in STZ-induced diabetic rats. The lack of a significant change in the peripheral arc may minimize reflex sympathetic activation, thereby enhancing a cardioprotective benefit of empagliflozin.

Keywords: Arterial pressure; Equilibrium diagram; Sodium–glucose cotransporter 2; Sympathetic nerve activity; Urine flow.

MeSH terms

  • Animals
  • Baroreflex* / drug effects
  • Benzhydryl Compounds* / pharmacology
  • Blood Pressure / drug effects
  • Diabetes Mellitus, Experimental* / drug therapy
  • Diabetes Mellitus, Experimental* / physiopathology
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology
  • Glucosides* / pharmacology
  • Male
  • Rats
  • Rats, Wistar
  • Sodium-Glucose Transporter 2 Inhibitors* / pharmacology
  • Streptozocin
  • Sympathetic Nervous System* / drug effects
  • Sympathetic Nervous System* / physiopathology
  • Urination / drug effects

Substances

  • Benzhydryl Compounds
  • empagliflozin
  • Glucosides
  • Sodium-Glucose Transporter 2 Inhibitors
  • Streptozocin