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Two-year administration of sodium-glucose co-transporter 2 inhibitor brought about marked reduction of body fat independent of skeletal muscle amount or glycemic improvement in Japanese patients with type 2 diabetes

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Abstract

Aim

To investigate long-term effects of sodium-glucose co-transporter 2 inhibitor (SGLT2i) on anthropometric and metabolic factors in Japanese patients with type 2 diabetes (T2DM).

Patients and Methods

This is a retrospective observation study. Forty-six outpatients with T2DM (32 men and 14 women, 51 ± 13 years old, BMI 27.9 ± 4.8, means ± S.D.) who had been treated by SGLT2i for 2 years were selected and their metabolic and anthropometric data were retrieved from medical records retrospectively. Regular instruction for diet and exercise had been performed throughout the administration of SGLT2i in outpatient clinic basis.

Results

By the administration of SGLT2i for 2 years, body weight and body fat amount were significantly reduced (P < 0.0001) in spite of no change in skeletal muscle mass. HbA1c (P < 0.0001), liver function and lipid profile (P < 0.01) were ameliorated and eGFR was reduced significantly (P < 0.0001). It is of note that the reduction of body weight was strongly correlated to that of body fat (r = 0.951, P < 0.0001) with no correlation to the change of skeletal muscle mass. The reduction of HbA1c was strongly correlated to the baseline HbA1c (r =  − 0.922, P < 0.0001) and modestly correlated to the baseline eGFR (r =  − 0.449, P < 0.01). Multivariate analysis revealed a weak relationship between the amelioration of HbA1c and the reduction of body weight.

Conclusion

SGLT2i can effectively reduce body weight and body fat mass independent of the blood glucose improvement or the renal function. Under the periodical instruction for nutrition and exercise this oral hypoglycemic agent can be safely administered for a long term without a risk for sarcopenia.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Kurume University School of Medicine, Kurume, Japan

    Moeko Sakamoto, Yuka Goto, Ayako Nagayama, Mamiko Yano, Yuji Tajiri & Masatoshi Nomura

  2. Yame General Hospital, Yame, Japan

    Moeko Sakamoto & Shuichi Sato

  3. Futata Tetsuhiro Clinic, Fukuoka, Japan

    Shuichi Sato

Authors
  1. Moeko Sakamoto
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  2. Yuka Goto
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  3. Ayako Nagayama
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  4. Mamiko Yano
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  5. Shuichi Sato
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  6. Yuji Tajiri
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  7. Masatoshi Nomura
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Correspondence to Yuji Tajiri.

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Sakamoto, M., Goto, Y., Nagayama, A. et al. Two-year administration of sodium-glucose co-transporter 2 inhibitor brought about marked reduction of body fat independent of skeletal muscle amount or glycemic improvement in Japanese patients with type 2 diabetes. Diabetol Int 13, 117–123 (2022). https://doi.org/10.1007/s13340-021-00512-7

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  • DOI: https://doi.org/10.1007/s13340-021-00512-7

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