The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism

Background. There is a lack of studies focusing on the combined impact of metformin, empagliflozin, and levothyroxine on the gut microbiota in patients with type 2 diabetes mellitus (T2DM) and hypothyroidism. The purpose of the study was to examine how the combination of metformin and empagliflozin...

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Main Authors: K.A. Moskva, O.P. Kikhtyak, T.A. Kikhtiak, M.L. Farmaha, Y.L. Leshchuk, Y.S. Leshchuk
Format: Article
Language:English
Published: Zaslavsky O.Yu. 2024-06-01
Series:Mìžnarodnij Endokrinologìčnij Žurnal
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Online Access:https://iej.zaslavsky.com.ua/index.php/journal/article/view/1408
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author K.A. Moskva
O.P. Kikhtyak
T.A. Kikhtiak
M.L. Farmaha
Y.L. Leshchuk
Y.S. Leshchuk
author_facet K.A. Moskva
O.P. Kikhtyak
T.A. Kikhtiak
M.L. Farmaha
Y.L. Leshchuk
Y.S. Leshchuk
author_sort K.A. Moskva
collection DOAJ
description Background. There is a lack of studies focusing on the combined impact of metformin, empagliflozin, and levothyroxine on the gut microbiota in patients with type 2 diabetes mellitus (T2DM) and hypothyroidism. The purpose of the study was to examine how the combination of metformin and empagliflozin affects gut microbiota composition in patients with type 2 diabetes and hypothyroidism. Materials and methods. We enrolled 47 patients who have been receiving hormone replacement therapy with levothyroxine at a stable dose over the past 2 years and were newly diagnosed with T2DM. All participants were divided into two groups and received either metformin alone or metformin plus empagliflozin for 6 months. Metabolic and hormonal parameters were measured before and after treatment, and stool samples were analyzed using PCR sequencing. Results. The study found that in both groups, there was an improvement in carbohydrate metabolism, lipid profile, and liver transaminases after treatment. The group treated with metformin plus empagliflozin had a more significant reduction in glucose, glycated hemoglobin, and atherogenicity coefficient than the group treated with metformin alone. We also found that combination therapy resulted in lower levels of Firmicutes and an increase in the number of Actinobacteria, as well as a higher ratio of Bacteroides fragilis to Faecalibacterium prausnitzii. Conclusions. The study shows for the first time that the combination of metformin, empagliflozin, and levothyroxine can directly affect the gut microbiota composition in patients with T2DM and hypothyroidism. These changes may be necessary for treating this cohort of patients and require further investigation.
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spelling doaj-art-e1684b13879344ae97959d7aedb5b8f92024-11-10T19:05:51ZengZaslavsky O.Yu.Mìžnarodnij Endokrinologìčnij Žurnal2224-07212307-14272024-06-0120429229610.22141/2224-0721.20.4.2024.14081406The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidismK.A. Moskva0https://orcid.org/0000-0003-3366-1975O.P. Kikhtyak1https://orcid.org/0000-0002-1261-1939T.A. Kikhtiak2https://orcid.org/0009-0001-9619-684XM.L. Farmaha3https://orcid.org/0000-0003-1298-4644Y.L. Leshchuk4https://orcid.org/0000-0002-9214-5762Y.S. Leshchuk5https://orcid.org/0000-0002-5724-9646Danylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineCommunal Non-Commercial Enterprise of the Lviv Regional Council “Lviv Regional Clinical Hospital”, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineDanylo Halytsky Lviv National Medical University, Lviv, UkraineBackground. There is a lack of studies focusing on the combined impact of metformin, empagliflozin, and levothyroxine on the gut microbiota in patients with type 2 diabetes mellitus (T2DM) and hypothyroidism. The purpose of the study was to examine how the combination of metformin and empagliflozin affects gut microbiota composition in patients with type 2 diabetes and hypothyroidism. Materials and methods. We enrolled 47 patients who have been receiving hormone replacement therapy with levothyroxine at a stable dose over the past 2 years and were newly diagnosed with T2DM. All participants were divided into two groups and received either metformin alone or metformin plus empagliflozin for 6 months. Metabolic and hormonal parameters were measured before and after treatment, and stool samples were analyzed using PCR sequencing. Results. The study found that in both groups, there was an improvement in carbohydrate metabolism, lipid profile, and liver transaminases after treatment. The group treated with metformin plus empagliflozin had a more significant reduction in glucose, glycated hemoglobin, and atherogenicity coefficient than the group treated with metformin alone. We also found that combination therapy resulted in lower levels of Firmicutes and an increase in the number of Actinobacteria, as well as a higher ratio of Bacteroides fragilis to Faecalibacterium prausnitzii. Conclusions. The study shows for the first time that the combination of metformin, empagliflozin, and levothyroxine can directly affect the gut microbiota composition in patients with T2DM and hypothyroidism. These changes may be necessary for treating this cohort of patients and require further investigation.https://iej.zaslavsky.com.ua/index.php/journal/article/view/1408diabetes mellitushypothyroidismmetforminempagliflozingut microbiotagut microbiota
spellingShingle K.A. Moskva
O.P. Kikhtyak
T.A. Kikhtiak
M.L. Farmaha
Y.L. Leshchuk
Y.S. Leshchuk
The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
Mìžnarodnij Endokrinologìčnij Žurnal
diabetes mellitus
hypothyroidism
metformin
empagliflozin
gut microbiotagut microbiota
title The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
title_full The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
title_fullStr The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
title_full_unstemmed The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
title_short The influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
title_sort influence of metformin and empagliflozin administration on gut microbiota in individuals with type 2 diabetes mellitus and hypothyroidism
topic diabetes mellitus
hypothyroidism
metformin
empagliflozin
gut microbiotagut microbiota
url https://iej.zaslavsky.com.ua/index.php/journal/article/view/1408
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