SGLT2阻害薬の長期使用に関連する体組成変化のメタアナリシス

This systematic review and meta-analysis evaluated the long-term effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors on body composition in patients with type 2 diabetes, focusing specifically on fat mass and fat-free mass. A comprehensive search was conducted using PubMed, Cochrane Library, and Embase from inception to April 22, 2024, to identify randomized controlled trials with at least 12 months of follow-up. The review included five trials involving a total of 695 participants. Compared to control groups, SGLT2 inhibitors significantly reduced fat mass (mean difference [MD], -1.26 kg; 95% confidence interval [CI], -2.26 to -0.26; p = 0.014) and body weight (MD, -3.24 kg; 95% CI, -4.38 to -2.10; p < 0.0001). However, no significant differences were observed in fat-free mass (MD, -0.53 kg; 95% CI, -1.62 to 0.56; p = 0.34) or waist circumference (MD, -0.96 cm; 95% CI, -3.30 to 1.37; p = 0.42). These findings suggest that SGLT2 inhibitor therapy reduces fat mass and body weight while preserving fat-free mass, indicating a possible protective effect on muscle and other lean components. Nevertheless, the limited number and heterogeneity of the included studies require cautious interpretation.