SGLT2 inhibitors could help in weight reduction and scale back fats mass in folks with kind 2 diabetes

A systematic review and meta-analysis provides insight into the effects of SGLT2 inhibitor use on body composition in people with type 2 diabetes.

The results of the study, which included data from more than a dozen studies, describe the positive effects of using SGLT2 inhibitors on body weight, BMI, waist circumference and fat mass, but also shed light on the potential negative effects on muscle mass.

“The highlight of this meta-analysis is to confirm not only the benefits of SGLT2 inhibitors in improving body composition, such as weight loss, BMI, waist circumference, visceral fat area, subcutaneous fat area, body fat percentage and fat mass reduction, but also the negative effects of these drugs target muscle mass reduction,” the researchers wrote.

In recent years, few, if any, therapeutic areas of cardiometabolic health have seen a revolution in use as hypoglycemic agents. As SGLT2 inhibitors have garnered headlines for their cardio-renal protective benefits, GLP-1 receptor agonists have expanded their role in weight control outside of diabetes. Although reported in studies, many questions remain related to the potential magnitude of weight loss and the compositional implications of using SGLT2 inhibitors.

Citing this and an interest in exploring a possible association with an increased risk of sarcopenia, a team from Cangzhou Central Hospital designed the present systematic review and meta-analysis of randomized clinical trials evaluating the use of SGLT2 inhibitors in people with type 2 -Diabetes was examined. Searching the PubMed, Cochrane Library, Embase and Web of Science databases for randomized clinical trials investigating the use of SGLT2 inhibitors published from 2013 to 2022, the researchers identified 18 trials totaling 1430 participants for inclusion. Of the studies, 3 examined canagliflozin, 8 dapagliflozin, 3 empagliflozin and 4 ipragliflozin.

Findings of interest for the researchers’ analyzes included changes in body weight, BMI, waist circumference, percentage body fat, fat mass, muscle mass, visceral fat area, subcutaneous fat area, lean mass, and skeletal muscle mass. Investigators noted that results were compared using mean weight difference (WMD).

In 14 randomized clinical trials that reported body weight, results indicated that use of SGLT2 inhibitors was associated with significantly decreased body weight compared to the trial comparators (WMD, -2.73 kg [95% CI , -3.32 to -2.13]; P < 0.00001), with investigators reporting little between-study heterogeneity (I2 = 33%).

Further analysis revealed that use of ASGLT2 inhibitors was associated with a reduction in girth (WMD, -2.20 cm [95% CI, -3.81 to -0.58]; P=0.008), visceral fat area (WMD, -14.79 cm2 [95%CI, -24.65 to -4.93] P=0.003), subcutaneous fat area (WMD, -23.27 cm2, 95% CI: -46.44 to -0.11]; P=0.05), fat mass (WMD, -1.16 kg [95%CI, -2.01 to -0.31]; P= 0.008), percentage body fat (WMD, -1.50% [95% CI, -2.12 to -0.87]; P<.00001). Investigators also noted that use of SGLT2 inhibitors was associated with a statistically significant decrease in lean mass (WMD, -0.76 kg [95% CI, -1.53 to 0.01]; P=0.05) and skeletal muscle mass (WMD, -1.01 kg [95% CI, -1.91 to -0.11]; P=0.03).

“Until there is more evidence that SGLT-2 inhibitors increase the risk of sarcopenia, not only the body composition benefits but also the side effects of reducing muscle mass by SGLT-2 inhibitors in T2DM should be considered,” concluded investigators .

This study “Effect of SGLT-2 inhibitors on body Composition in Patients with Type 2 Diabetes mellitus: A Meta-Analysis of Randomized Controlled Trials” was published in PLOS ONE.

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