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

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.