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The effects of empagliflozin vs metformin on endothelial microparticles in overweight/obese women with polycystic ovary syndrome

Javed, Zeeshan; Papageorgiou, Maria; Madden, Leigh A.; Rigby, Alan S.; Kilpatrick, Eric S.; Atkin, Stephen L.; Sathyapalan, Thozhukat


Zeeshan Javed

Maria Papageorgiou

Alan S. Rigby

Eric S. Kilpatrick

Stephen L. Atkin

Thozhukat Sathyapalan


Context: Endothelial microparticles (EMPs) are novel, surrogate biomarkers of endothelial function and have been shown to be elevated in women with polycystic ovary syndrome (PCOS). It remains poorly understood how pharmacological options for managing PCOS affect EMP levels. Objective: To characterise and compare the effects of empagliflozin vs metformin on the circulating levels of EMPs in overweight/obese women with PCOS. Methods: This was a randomised, comparative, 12-week single-centre trial conducted at the Academic Diabetes, Endocrinology and Metabolism Research Centre, Hull, UK. This analysis includes data from 39 overweight/obese women with PCOS who completed the study and were randomised to empagliflozin (15 mg/day) (n = 19) or metformin (1500 mg/day) (n = 20). Blood samples were collected at baseline and 12 weeks after treatment and analysed for specific surface proteins (ICAM-1, VCAM-1, PECAM-1, E-selectin and endoglin) expressed by circulating EMPs using flow cytometry. Results: In the empagliflozin group, ICAM-1 (P = 0.006), E-selectin (P = 0.016) and VCAM-1 (P = 0.001) EMPs increased significantly following 12 weeks of treatment, but no changes were seen in PECAM-1 (P = 0.93) or endoglin (P = 0.13) EMPs. In the metformin group, VCAM-1 EMPs (P < 0.001) increased significantly after 12 weeks of treatment, whereas all other EMPs remained unchanged. When data were expressed as percentage change from baseline in each group, no significant differences were seen between groups for any biomarker (P-values from 0.22 to 0.80). Conclusions: Short-term administration of empagliflozin and metformin in overweight/ obese women with PCOS appear to increase EMPs expressed by endothelial cells during their activation.


Javed, Z., Papageorgiou, M., Madden, L. A., Rigby, A. S., Kilpatrick, E. S., Atkin, S. L., & Sathyapalan, T. (2020). The effects of empagliflozin vs metformin on endothelial microparticles in overweight/obese women with polycystic ovary syndrome. Endocrine Connections, 9(6), 563-569.

Journal Article Type Article
Acceptance Date May 20, 2020
Online Publication Date Jun 19, 2020
Publication Date 2020-06
Deposit Date Oct 7, 2020
Publicly Available Date Oct 9, 2020
Journal Endocrine Connections
Print ISSN 2049-3614
Electronic ISSN 2049-3614
Publisher BioScientifica
Peer Reviewed Peer Reviewed
Volume 9
Issue 6
Pages 563-569
Keywords Endothelial microparticles; Polycystic ovary syndrome; SGLT2 inhibitors; Empagliflozin; Metformin
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