Sleep & breathing = Schlaf & Atmung · 2026
Temporal changes in obstructive sleep apnea severity and body composition parameters during 6-month tofogliflozin administration in patients with heart failure and type 2 diabetes mellitus: a TOPARDS-HF substudy.
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Ishiwata Sayaki, Kasai Takatoshi, Sato Akihiro, Suda Shoko, Matsumoto Hiroki, Shitara Jun, Yatsu Shoichiro, Murata Azusa, Shimizu Megumi, Kato Takao, Hiki Masaru, Shiroshita Nanako, Kato Mitsue, Kawana Fusae, Naito Ryo, Miyauchi Katsumi, Daida Hiroyuki, Minamino Tohru
Аннотация
PURPOSE: Obstructive sleep apnea (OSA) is closely associated with obesity and fluid retention. Our previous study suggested that, in patients with heart failure, the sodium-glucose cotransporter 2 inhibitor, tofogliflozin, promotes diuresis and weight loss and improves OSA severity. However, whether changes in the apnea-hypopnea index (AHI) are chronologically associated with body composition parameters remains unclear.
METHODS: We enrolled 10 patients (six men) with OSA. They received tofogliflozin (20 mg) daily for 6 months. The AHI was assessed using WatchPAT® at baseline, 3, and 6 months. Body composition, including water content and fat mass, was also measured. AHI changes measured using the WatchPAT peripheral arterial tonometry-derived AHI (pAHI) and their correlations with changes in body composition parameters were analyzed.
RESULTS: Tofogliflozin administration significantly reduced pAHIs at 3 and 6 months compared to baseline, but more at 3 months, whereas body weight and body water content decreased over time. The %Δbody water content did not correlate with %ΔpAHI at 3 months (r = 0.47, p = 0.139), but there was a significant correlation at 6 months (r = 0.57, p = 0.047). The %Δbody weight and %Δfat mass reduction were significantly associated with improvement in %ΔpAHI at 3 months (r = 0.65, p = 0.042 and r = 0.66, p = 0.044, respectively), but no correlations were observed at 6 months.
CONCLUSIONS: Tofogliflozin significantly improved OSA severity at 3 and 6 months; however, more improvements were observed at 3 months. These improvements were accompanied by gradual reductions in body water content, especially from baseline to 6 months. In contrast, body weight and fat mass reduction impacted the OSA severity in the early stages.
METHODS: We enrolled 10 patients (six men) with OSA. They received tofogliflozin (20 mg) daily for 6 months. The AHI was assessed using WatchPAT® at baseline, 3, and 6 months. Body composition, including water content and fat mass, was also measured. AHI changes measured using the WatchPAT peripheral arterial tonometry-derived AHI (pAHI) and their correlations with changes in body composition parameters were analyzed.
RESULTS: Tofogliflozin administration significantly reduced pAHIs at 3 and 6 months compared to baseline, but more at 3 months, whereas body weight and body water content decreased over time. The %Δbody water content did not correlate with %ΔpAHI at 3 months (r = 0.47, p = 0.139), but there was a significant correlation at 6 months (r = 0.57, p = 0.047). The %Δbody weight and %Δfat mass reduction were significantly associated with improvement in %ΔpAHI at 3 months (r = 0.65, p = 0.042 and r = 0.66, p = 0.044, respectively), but no correlations were observed at 6 months.
CONCLUSIONS: Tofogliflozin significantly improved OSA severity at 3 and 6 months; however, more improvements were observed at 3 months. These improvements were accompanied by gradual reductions in body water content, especially from baseline to 6 months. In contrast, body weight and fat mass reduction impacted the OSA severity in the early stages.