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Sodium-Glucose Cotransporter 2 Inhibitors Improve Body Composition by Increasing the Skeletal Muscle Mass/Fat Mass

Sara Volpe1, Alfredo Vozza1, Giuseppe Lisco1

  • 1Interdisciplinary Department of Medicine, School of Medicine, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.

Nutrients
|November 27, 2024
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 inhibitors (SGLT2is) aid weight loss in type 2 diabetes patients by reducing fat mass, not skeletal muscle mass. This therapy also improves liver steatosis without negatively impacting muscle strength.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Pharmacology

Background:

  • Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are known to induce weight loss.
  • The impact of SGLT2is on skeletal muscle mass (SMM) and strength requires further investigation, particularly in real-world clinical settings.

Purpose of the Study:

  • To evaluate the effects of SGLT2 inhibitors on skeletal muscle mass in patients with type 2 diabetes.
  • To assess secondary outcomes including changes in liver steatosis, anthropometric, and glucometabolic parameters.

Main Methods:

  • A real-world study involving 71 patients with type 2 diabetes treated with SGLT2 inhibitors as add-on therapy to metformin for 52 weeks.
  • Data collection included anthropometric measurements, bioimpedance analysis for body composition, and abdominal ultrasound for liver steatosis assessment at baseline, 6 months, and 12 months.

Main Results:

  • SGLT2 inhibitor therapy led to significant reductions in fat mass and visceral adipose tissue.
  • While skeletal muscle mass showed a slight decrease, the ratio of SMM to fat mass improved significantly.
  • Improvements were observed in anthropometric and glucometabolic parameters, insulin resistance, and hepatic steatosis.

Conclusions:

  • In a real-world setting, SGLT2 inhibitors promote weight loss primarily through fat mass reduction, without significant loss of skeletal muscle mass or strength.
  • SGLT2 inhibitors demonstrate beneficial effects on non-alcoholic fatty liver disease in patients with type 2 diabetes.
Keywords:
body compositionfat massreal-life studysarcopeniasarcopenic obesityskeletal muscle masssodium glucose transporter 2 inhibitors (SGLT2is)type 2 diabetesvisceral adipose tissue

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