Age different effects of SGLT2 inhibitors on body composition in individuals with type 2 diabetes: A retrospective cohort study

IF 2.9 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-05-11 DOI:10.1016/j.jdiacomp.2025.109068

Kengo Miyoshi, Tomohisa Aoyama, Saori Kameda, Nagisa Ishibashi, Yumi Sakai, Takao Yamanaka, Tomoya Kawaguchi, Yuri Kadowaki, Toshimasa Yamauchi

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Abstract

Purpose

This study investigates the long-term impact of sodium-glucose cotransporter 2 inhibitors (SGLT2i)on body composition in individuals with type 2 diabetes (T2D), with a focus on age-related differences. We evaluated changes in body mass index (BMI), body fat percentage, skeletal muscle mass and skeletal muscle mass index (SMI) over 4.4 years on average.

Methods

This retrospective, single-center clinical cohort study utilized electronic medical records from the University of Tokyo Hospital. 70 people with T2D treated with SGLT2i for more than two years were included. Body compositions were assessed using bioelectrical impedance analysis (BIA) at three time points: before SGLT2i therapy, 1 year after SGLT2 therapy initiation and the latest along with SGLT2i therapy.

Results

During the 4.4-year average treatment period, significant reductions were observed in BMI (30.5 to 29.1, p < 0.0001) and skeletal muscle mass (30.3 kg to 29.0 kg, p < 0.0001). ΔBMI was positively correlated with ΔBody fat percentage and ΔSkeletal muscle mass (all p < 0.0001). Age-stratified analysis showed that in younger individuals, ΔSkeletal muscle mass was significantly associated with both treatment duration and ΔBMI. In contrast, older individuals showed a weaker correlation between ΔSkeletal muscle mass and ΔBMI, and experienced significant muscle mass decline at an earlier point.

Conclusion

SGLT2i are effective in managing T2D and reducing BMI and body fat. However, careful monitoring of body composition is crucial, especially in older individuals, to mitigate the risk of sarcopenia and maintain overall health.

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年龄不同的SGLT2抑制剂对2型糖尿病患者体成分的影响：一项回顾性队列研究

目的：本研究探讨钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）对2型糖尿病（T2D）患者体成分的长期影响，重点关注年龄相关差异。我们评估了平均4.4年的身体质量指数（BMI）、体脂率、骨骼肌质量和骨骼肌质量指数（SMI）的变化。方法：这项回顾性、单中心临床队列研究利用东京大学医院的电子病历，纳入了70例接受SGLT2i治疗两年以上的T2D患者。使用生物电阻抗分析（BIA）在三个时间点评估体成分：SGLT2i治疗前、SGLT2治疗开始后1年和最新的SGLT2i治疗期间。结果在4.4年的平均治疗期间，BMI显著降低(30.5 ~ 29.1,p <；0.0001)和骨骼肌质量(30.3 kg至29.0 kg, p <；0.0001)。ΔBMI与ΔBody脂肪率和ΔSkeletal肌肉量呈正相关(p <；0.0001)。年龄分层分析显示，在年轻人中，ΔSkeletal肌肉质量与治疗时间和ΔBMI显著相关。相比之下，老年人的ΔSkeletal肌肉质量和ΔBMI之间的相关性较弱，并且在较早的时候经历了显著的肌肉质量下降。结论sglt2i能有效控制T2D，降低BMI和体脂。然而，仔细监测身体成分是至关重要的，特别是对老年人来说，这可以减轻肌肉减少症的风险，保持整体健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.