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. 2021 Feb 16;106(5):1269–1283. doi: 10.1210/clinem/dgab086

Table 3.

Concentrations of Urine metabolites in patients with type 2 diabetes mellitus before and 3 months after administration of dapagliflozin and insulin degludec

Metabolite concentration
(μmol/mmol creatinine)
Baseline Posttreatment 2-way analysisa
Dapagliflozin Insulin
Controls Dapagliflozin Insulin % change P % change P F P
1-methylnicotinamide 1.97 ± 0.70 2.72 ± 1.70* 1.60 ± 0.49+ −6.6 NS +15 NS 0.91 NS
1-methylhistidine 9.44 ± 8.24 26.54 ± 14.14** 13.18 ± 10.11* +2.4 NS +17.7 NS 0.14 NS
2-aminobutyrate 4.08 ± 2.02 6.46 ± 2.83** 5.85 ± 4.34** +14.4 <0.0005 +6.6 NS 8.92 <0.05
2-hydroxy-3-methylvalerate 3.87 ± 1.67 11.46 ± 6.34** 5.56 ± 2.91*+ +17.3 <0.0005 +10.2 NS 4.12 <0.05
2-hydroxybutyrate 1.91 ± 1.12 1.20 ± 1.00 3.61 ± 1.64*+ +30 <0.0005 +22.2 NS 3.71 <0.05
2-hydroxyisobutyrate 5.66 ± 1.50 8.80 ± 3.08** 4.31 ± 2.56+ −7.6 NS +5.8 NS 1.61 NS
2-hydroxyisovalerate 1.43 ± 0.59 4.72 ± 1.62** 1.79 ± 1.22++ +14.5 <0.0005 −1.1 NS 4.37 <0.05
2-hydroxyvalerate 2.36 ± 1.33 7.54 ± 6.29** 3.33 ± 2.28+ +2.9 NS +16.7 NS 0.06 NS
2-oxocaproate 3.58 ± 1.66 2.7 ± 2.03 4.45 ± 3.72 +0.2 NS −13.1 NS 0.71 NS
3-chlorotyrosine 9.10 ± 12.40 24.17 ± 17.02** 20.25 ± 19.27** −30.5 <0.0001 +4.9 NS 3.90 <0.05
3-hydroxybutyrate 12.93 ± 13.10 46.00 ± 41.78** 30.46 ± 20.02**+ +21.2 <0.0005 −43.1 <0.0005 7.25 <0.05
3-hydroxyisobutyrate 11.12 ± 10.21 12.34 ± 10.96 13.50 ± 12.91 +15.2 NS −11.1 NS 2.28 NS
3-hydroxyisovalerate 5.16 ± 1.73 4.78 ± 2.83 3.40 ± 2.53* +18 <0.0005 +5.3 NS 3.44 <0.05
3-indoxylsulfate 13.85 ± 8.41 30.6 ± 17.61** 21.17 ± 10.35**+ −4.4 NS +11.3 NS 0.69 NS
3-methyl-2-oxovalerate 3.98 ± 2.05 12.23 ± 7.54** 9.33 ± 4.88**+ −18.4 NS −10.6 NS 4.32 <0.05
3-methyladipate 2.96 ± 1.85 7.32 ± 6.45** 6.65  ± 4.34** +19.1 NS +8.5 NS 0.92 NS
3-methylhistidine 15.70 ± 8.37 27.16 ± 17.85** 22.15 ± 19.22** −1.8 NS +5.7 NS 0.54 NS
4-hydroxybenzoate 3.14 ± 2.51 5.90 ± 5.76* 5.50 ± 3.97* +7.9 NS +40.1 NS 2.64 NS
Acetate 15.20 ± 11.22 28.07 ± 9.25* 20.86 ± 11.68 −1.3 NS +23.5 NS 1.06 NS
Acetoacetate 14.08 ± 13.53 43.68 ± 16.68** 36.05 ± 18.06** +18.5 <0.0005 −45.2 <0.0005 36.68 <0.01
Acetone 4.21 ± 2.07 3.35 ± 2.10 5.49 ± 4.72 +14 NS −10.7 NS 1.05 NS
Alanine 21.25 ± 9.36 44.63 ± 30.47** 40.45 ± 24.93** +26.5 <0.0001 +13.1 NS 3.42 <0.05
Allantoin 10.38 ± 6.83 8.55 ± 5.18 6.64 ± 5.58 +7.2 NS +7.3 NS 0.25 NS
Anserine 6.57 ± 3.79 9.76 ± 4.51* 8.64 ± 6.32 −19.4 <0.0005 −8.3 NS 4.58 <0.05
Betaine 12.96 ± 7.74 72.87 ± 48.04** 76.92 ± 42.12** +54.9 <0.0001 −58.3 <0.0005 9.22 <0.01
Butyrate 3.35 ± 1.71 1.69 ± 0.98* 1.05 ± 0.84* +15.4 NS +2.6 NS 1.20 NS
Carnitine 8.12 ± 6.57 6.75 ± 5.85 6.73 ± 7.33 −15.9 NS −10.4 NS 0.02 NS
Choline 5.68 ± 4.18 6.69 ± 4.78 5.35 ± 4.08 +13.5 NS +11.2 NS 0.07 NS
cis-Aconitate 22.11 ± 14.96 16.56 ± 8.73 15.27 ± 7.84 −10.9 NS +9.2 NS 3.02 NS
Citrate 347.10 ± 181.68 357.30 ± 233.27 373.18 ± 273.63 +18.4 <0.0005 −10.5 NS 3.85 <0.05
Creatine 12.62 ± 12.69 49.65 ± 31.64** 50.69 ± 37.23** +40.3 <0.0001 +2.3 NS 4.22 <0.05
Creatine phosphate 26.61 ± 18.70 155.92 ± 188.61** 143 ± 127.89** +1.6 NS −6.1 NS 0.04 NS
Cytosine 5.16 ± 3.64 3.35 ± 2.59 6.34 ± 5.58 +1.2 NS −9.6 NS 0.95 NS
Dimethylamine 35.05 ± 12.24 24.67 ± 10.92* 27.23 ± 14.85 +0.1 NS +18.5 NS 0.68 NS
Ethylmalonate 4.02 ± 1.89 1.64 ± 0.97** 1.92 ± 1.34** +33.5 <0.0001 +4.6 NS 6.52 <0.01
Formate 27.89 ± 16.14 22.92 ± 11.72 21.45 ± 21.31 −4.8 NS +24.2 NS 0.56 NS
Fumarate 0.80 ± 0.56 1.00 ± 0.72 1.23 ± 1.12 −2.0 NS −14.6 NS 0.66 NS
Gluconate 44.28 ± 18.37 45.55 ± 25.23 37.58 ± 26.88 +33.26 <0.0005 +7.2 NS 5.42 <0.05
Glucose 39.55 ± 14.13 2273 ± 5551** 1175 ± 2174* +723.6 <0.0001 −68.1 <0.0005 31.18 <0.01
Glycine 124.18 ± 78.18 121.35 ± 78.74 86.65 ± 76.54 −7.7 NS +5.8 NS 0.05 NS
Hippurate 325.72 ± 255.79 327.06 ± 259.02 300.01 ± 349.25 +33.3 <0.0005 +7.7 NS 6.33 <0.05
Hypoxanthine 7.59 ± 8.02 5.55 ± 5.05 4.41 ± 4.76 −18.9 NS +19.5 NS 5.88 <0.05
Indole-3-acetate 6.32 ± 5.03 6.01 ± 4.11 9.35 ± 7.18 −3.3 NS +8.2 NS 0.65 NS
Indole-3-lactate 7.76 ± 8.11 13.03 ± 6.27* 9.35 ± 8.42 −8.5 NS +5.6 NS 0.58 NS
Isoleucine 2.25 ± 1.01 6.46 ± 3.62* 9.88 ± 6.43** +13.3 NS −9.2 NS 2.85 NS
Kynurenate 2.29 ± 1.66 2.86 ± 2.13 4.17 ± 2.84* +32.1 NS +28.2 NS 0.74 NS
Lactate 7.94 ± 4.74 12.93 ± 8.43** 11.16 ± 7.02** +116 <0.0001 −25.2 <0.0005 9.82 <0.01
Leucine 2.50 ± 1.28 11.27 ± 4.31** 9.04 ± 9.03** +22.2 <0.0005 −8.5 NS 4.88 <0.05
Lysine 19.82 ± 15.37 57.45 ± 17.51** 46.83 ± 47.27** +7.2 NS −7.3 NS 1.30 NS
Mannitol 49.68 ± 20.93 72.21 ± 41.17 83.22 ± 117.08 +7.7 NS −11.3 NS 0.23 NS
Methanol 47.61 ± 30.70 23.31 ± 12.45** 16.09 ± 13.63** −22.7 <0.0005 +18 NS 6.10 <0.05
Methylamine 4.79 ± 5.02 5.52 ± 3.86 4.92 ± 4.42 −4.3 NS −7.11 NS 0.10 NS
Myo-inositol 42.23 ± 26.31 87.61 ± 71.31** 82.88 ± 68.71** +77.1 <0.0001 −32.5 <0.0005 14.49 <0.01
N,N-dimethylglycine 2.73 ± 1.38 4.47 ± 3.60 3.54 ± 3.11 +233.8 <0.0001 +1.4 NS 13.92 <0.01
N-isovaleroylglycine 1.37 ± 0.66 3.39 ± 1.91** 2.13 ± 1.54* −17.7 <0.0005 +13.6 NS 4.89 <0.05
N-methylhydantoin 10.33 ± 5.45 20.83 ± 9.15** 22.44 ± 21.34** +16 <0.0005 +2.9 NS 4.32 <0.05
N-phenylacetylglycine 34.99 ± 13.70 49.64 ± 30.41* 58.90 ± 43.36** +13.1 NS −12.1 NS 4.81 <0.05
Phenylalanine 11.40 ± 12.43 46.72 ± 39.10** 30.19 ± 28.36**+ −5.2 NS +38.1 NS 2.25 NS
Pyruvate 4.40 ± 2.52 5.56 ± 3.17 5.05 ± 3.20 −3.9 NS −3.9 NS 0.06 NS
Sarcosine 6.07 ± 7.46 1.66 ± 0.88** 1.98 ± 1.53** +109 <0.0005 −14.1 NS 56.31 <0.01
Succinate 5.29 ± 3.39 12.49 ± 5.89 13.99 ± 12.4* +5.8 NS −2.3 NS 0.03 NS
Threonine 21.59 ± 10.92 36.61 ± 21.63* 29.20 ± 22.91 +10.4 NS +10.5 NS 0.01 NS
trans-Aconitate 5.26 ± 4.18 4.24 ± 3,81 2.94 ± 1.91 −24.5 NS +0.7 NS 2.41 NS
Trigonelline 33.46 ± 35.39 35.69 ± 28.77 43.02 ± 19.15 +96.1 <0.0001 +7.6 NS 22.37 <0.01
Trimethylamine 2.08 ± 0.96 3.79 ± 1.91 4.34 ± 4.13 −2.6 NS +3.7 NS 0.22 NS
Trimethylamine N-oxide 50.40 ± 41.32 36.38 ± 37.80 36.63 ± 28.06 −16.8 NS +2.9 NS 0.47 NS
Tyrosine 6.78 ± 3.82 19.11 ± 7.38** 15.81 ± 14.69** +9.4 NS −2.1 NS 0.29 NS
Valerate 4.69 ± 3.20 20.96 ± 11.73** 15.95 ± 13.00** −28.72 NS +1.2 NS 1.99 NS
Valine 3.63 ± 1.28 8.56 ± 4.10** 3.11 ± 1.91++ +35.1 <0.0001 +19.2 NS 4.45 <0.05
Xanthurenate 9.81 ± 10.26 18.17 ± 12.75* 12.15 ± 28.24 +11.8 NS +28.2 NS 1.23 NS

a F- and P-values for the treatment*time point interaction.

* P < 0.0005 and **P < 0.0001 compared to control group baseline values.

+ P < 0.0005 and ++P < 0.0001 compared to dapagliflozin group baseline values.