Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Body Composition and Fluid Status in Cardiovascular Rehabilitation Patients with Coronary Artery Disease and Heart Failure.

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
José C De La Flor, Blanca Coto Morales, Elena Basabe, María Rey Hernandez, Rocío Zamora González-Mariño, Celia Rodríguez Tudero, Irwing Benites Flores, Carlos Espinoza, Michael Cieza Terrones, Secundino Cigarrán Guldris, Jesús Hernández Vaquero
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引用次数: 0

Abstract

Background and Objectives: Sodium glucose cotransporter-2 (SGLT-2) inhibitors have emerged as integral therapeutic tools in the management of patients with cardiovascular-kidney-metabolic (CKM) syndrome. In addition to their well-documented effects on lowering glucose levels and cardiovascular- and reno-protective actions, SGLT-2 inhibitors, through a reduction in body weight (BW), generate changes in the body composition and volume status that have not been clearly studied. Materials and Methods: This retrospective, observational longitudinal cohort, single-center study analyzed and compared body composition and fluid status measured by bioelectrical impedance analysis (BIA) from weeks 0 to 12 after the initiation of the cardiac rehabilitation (CR) program for coronary artery disease and heart failure in 59 patients who started treatment with SGLT-2 inhibitors (SGLT-2iG) and 112 patients without SGLT-2 inhibitors (non-SGLT-2iG). Results: Changes between the baseline and week 12 in the SGLT-2iG and non-SGLT-2iG were -0.3 L (p = 0.003) and -0.03 L (p = 0.82) in extracellular water (ECW) (p = 0.05), -0.39 L (p < 0.001) and -0.14 L (p = 0.33) in intracellular water (ICW) (p = 0.12), -0.69 (p < 0.001) and -0.16 (p = 0.52) in total body water (TBW) (p = 0.08), and -0.01 (p = 0.37) and -0.001 (p = 0.25) in the ECW/TBW ratio, respectively. After 3 months of exercise therapy in the CR program, patients in the SGLT-2iG showed a greater decrease than the non-SGLT-2iG in weight (-1.34 kg, p < 0.001 vs. -0.99, p = 0.02), body mass index (BMI) (-0.45 kg/m2, p < 0.001 vs. -0.38, p = 0.004), arm circumference (-0.57 cm, p = 0.008 vs. -0.12 cm, p = 0.21), waist circumference (-1.5 cm, p = 0.04 vs. -0.11 cm, p = 0.83), systolic blood pressure (SBP) (-8.9 mmHg, p = 0.049 vs. -4.19, p = 0.08), and diastolic blood pressure (DBP) (-5.15, p = 0.03 vs. -2.85, p = 0.01). The bioelectrical impedance analysis (BIA) revealed a significant decrease in body fat mass (BFM) and visceral fat area, without a loss of lean body mass (LBM) or skeletal muscle mass in the SGLT-2iG. Conclusions: SGLT-2 inhibitors exert beneficial effects on body compartments and volume status. Although they induce modest weight loss, this appears to be mainly directed at ECW, BFM, and visceral fat, without a loss of LBM nor skeletal muscle mass, which could contribute to the observed CKM benefits.

钠-葡萄糖共转运蛋白-2抑制剂对冠心病和心力衰竭心血管康复患者体成分和体液状态的影响
背景和目的:葡萄糖共转运蛋白-2钠(SGLT-2)抑制剂已成为治疗心血管-肾代谢(CKM)综合征患者的综合治疗工具。SGLT-2抑制剂除了在降低血糖水平和心血管和肾保护作用方面的作用外,还通过降低体重(BW)产生身体组成和体积状态的变化,这一点尚未得到明确的研究。材料和方法:这项回顾性、观察性纵向队列、单中心研究分析和比较了59名开始接受SGLT-2抑制剂(SGLT-2iG)治疗的冠状动脉疾病和心力衰竭患者和112名未接受SGLT-2抑制剂(非SGLT-2iG)治疗的心脏康复(CR)计划开始后0至12周,通过生物电阻抗分析(BIA)测量的身体成分和液体状态。结果:基线之间的变化和第12周SGLT-2iG和non-SGLT-2iG -0.3 L (p = 0.003)和-0.03 L (p = 0.82)在细胞外的水(ECW) (p = 0.05), -0.39 L (p < 0.001)和-0.14 L (p = 0.33)在细胞内的水(ICW) (p = 0.12), -0.69 (p < 0.001)和-0.16 (p = 0.52)在全身水(TBW) (p = 0.08),和-0.01 (p = 0.37)和-0.001 (p = 0.25)的ECW / TBW比例,分别。经过3个月的运动疗法在CR程序,病人SGLT-2iG显示减少大于non-SGLT-2iG重量(-1.34公斤,p < 0.001与-0.99,p = 0.02),身体质量指数(BMI) (-0.45 kg / m2, p < 0.001与-0.38,p = 0.004),手臂周长(-0.57厘米,p = 0.008和-0.12厘米,p = 0.21),腰围(-1.5厘米,p = 0.04和-0.11厘米,p = 0.83),收缩压(SBP)(-8.9毫米汞柱,p = 0.049和-4.19,p = 0.08),和舒张压(菲律宾)(-5.15,P = 0.03 vs. -2.85, P = 0.01)。生物电阻抗分析(BIA)显示,SGLT-2iG的体脂质量(BFM)和内脏脂肪面积显著减少,而瘦体质量(LBM)或骨骼肌质量没有减少。结论:SGLT-2抑制剂对体室和体积状态有有益作用。虽然它们引起适度的体重减轻,但这似乎主要针对ECW, BFM和内脏脂肪,而没有LBM和骨骼肌质量的减少,这可能有助于观察到的CKM益处。
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来源期刊
Medicina-Lithuania
Medicina-Lithuania 医学-医学:内科
CiteScore
3.30
自引率
3.80%
发文量
1578
审稿时长
25.04 days
期刊介绍: The journal’s main focus is on reviews as well as clinical and experimental investigations. The journal aims to advance knowledge related to problems in medicine in developing countries as well as developed economies, to disseminate research on global health, and to promote and foster prevention and treatment of diseases worldwide. MEDICINA publications cater to clinicians, diagnosticians and researchers, and serve as a forum to discuss the current status of health-related matters and their impact on a global and local scale.
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