A Meta-Analysis of Body Composition Changes Associated With Long-term Use of Sodium-Glucose Cotransporter 2...

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are widely used in patients with type 2 diabetes, but their long-term effects on body composition remain unclear.

We conducted a systematic review and meta-analysis to evaluate the long-term effects of SGLT2 inhibitors on body composition, focusing on fat mass and fat-free mass. PubMed, the Cochrane Library, and Embase were searched from inception to April 22, 2024. Randomized controlled trials with at least 12 months of follow-up were included. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated.

Five randomized controlled trials involving 695 participants were included. Compared with control groups, SGLT2 inhibitors significantly reduced fat mass (MD, -1.26 kg; 95% CI, -2.26 to -0.26; P = .014) and body weight (MD, -3.24 kg; 95% CI, -4.38 to -2.10; P < .0001). No significant differences were observed in fat-free mass (MD, -0.53 kg; 95% CI, -1.62 to 0.56; P = .34) or waist circumference (MD, -0.96 cm; 95% CI, -3.30 to 1.37; P = .42).

SGLT2 inhibitor therapy is associated with reductions in fat mass and body weight while preserving fat-free mass. These findings suggest a potential protective effect on muscle and other lean components; however, the limited number and heterogeneity of the included studies warrant cautious interpretation.