Therapeutic Research

Abstract

Background：Sodium‒glucose cotransporter 2（SGLT2）inhibitors are oral hypoglycemic agents that are expected to be useful for diabetes patients with obesity. However, there is the concern that SGLT2 inhibitor may cause a loss of muscle mass and lead to sarcopenia. 　　Object：The purpose of this study was to evaluate the effects of the SGLT2 inhibitor tofogliflozin on body composition over a period of more than one year. 　　Method：We retrospectively recruited 11 type 2 diabetes patients who were newly treated with tofogliflozin；body composition was continuously assessed using bioelectrical impedance analysis and blood analyses （liver enzymes, renal function and lipid profile） were monitored for over one year. 　Results：Most of the recruited patients were middle age and obese（median age 56；interquartile range 50‒60, median BMI 31.2；interquartile range 28.6‒36.1）. Blood examinations were monitored for 5 years in all 11 patients. The body composition observation period was 5 years in 10 patients and 4 years in 1 patient. Tofogliflozin treatment significantly reduced body weight, and the effect was essentially maintained throughout the observation period. Body fat accounted for 96％ of the weight loss. Muscle mass and muscle ratio（muscle mass：body weight） was not changed in the study period. 　　Conclusion：Tofogliflozin did not decrease muscle mass or muscle ratio. Some patients received some additional treatments, such as GLP‒1 receptor agonists, hospitalization, or statin initiation during the observation period. As these treatments can affect the results, further study is needed to clarify the effects of tofogliflozin alone on body composition.