PMID- 29098566 OWN - NLM STAT- MEDLINE DCOM- 20180619 LR - 20221207 IS - 1179-1918 (Electronic) IS - 1173-2563 (Print) IS - 1173-2563 (Linking) VI - 38 IP - 1 DP - 2018 Jan TI - Clinical Factors Associated with Initial Decrease in Body-Fat Percentage Induced by Add-on Sodium-Glucose Co-transporter 2 Inhibitors in Patient with Type 2 Diabetes Mellitus. PG - 19-27 LID - 10.1007/s40261-017-0580-6 [doi] AB - BACKGROUND AND OBJECTIVE: Obesity is globally recognized as an important clinical problem and sodium-glucose co-transporter 2 (SGLT2) inhibitors are considered a suitable therapy for obese patients with type 2 diabetes mellitus (T2DM). We examined the clinical factors associated with initial decrease in body-fat percentage (Fat %) induced by SGLT2 inhibitors in patients with T2DM. METHODS: We retrospectively enrolled patients newly treated with SGLT2 inhibitors in addition to ongoing medications at Jinnouchi Hospital between April 2014 and December 2015. We examined the SGLT2 inhibitor-induced change in body composition by using a bioelectrical impedance analyzer (InBody770((R))) before SGLT2 inhibitor administration and after 4 weeks' treatment. RESULTS: A total of 175 patients with T2DM were enrolled and we analyzed 148 patients. Add-on SGLT2 inhibitor treatment significantly reduced body weight (- 1.04 +/- 1.18 kg, p < 0.01), total fat quantity (- 0.62 +/- 1.19 kg, p < 0.01), and Fat % (- 0.4 +/- 1.4%, p < 0.01). Pretreatment levels of glycated hemoglobin (HbA1c) [odds ratio (OR), 1.61; 95% confidence interval (CI), 1.15-2.25, p < 0.01] and smoking (OR, 2.65; 95% CI, 1.14-6.15, p = 0.02) were significantly associated factors for greater fat-reduction defined as more than 0.4% (median) decrease in Fat % in multivariate logistic regression analysis. In receiver operator characteristic analysis, the cut-off value of pretreatment levels of HbA1c for a greater Fat % decrease was 7.7% (sensitivity 53% and specificity 69%, p < 0.01). CONCLUSION: Additional treatment with SGLT2 inhibitors effectively decreased Fat % in T2DM patients with high HbA1c levels before SGLT2 inhibitor administration. Our results suggest a greater initial response in Fat % reduction to SGLT2 inhibitor therapy in diabetic patients with pretreatment HbA1c levels >/= 7.7%. FAU - Kurinami, Noboru AU - Kurinami N AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Sugiyama, Seigo AU - Sugiyama S AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. AD - Division of Cardiovascular Medicine, Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan. FAU - Nishimura, Hiroyuki AU - Nishimura H AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Morita, Ayami AU - Morita A AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Yoshida, Akira AU - Yoshida A AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Hieshima, Kunio AU - Hieshima K AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Miyamoto, Fumio AU - Miyamoto F AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Kajiwara, Keizo AU - Kajiwara K AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Jinnouchi, Katsunori AU - Jinnouchi K AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Jinnouchi, Tomio AU - Jinnouchi T AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. FAU - Jinnouchi, Hideaki AU - Jinnouchi H AD - Diabetes Care Center, Jinnouchi Hospital, 6-2-3 Kuhonji, Chuo-ku, Kumamoto, 862-0976, Japan. hideaki@jinnouchi.or.jp. LA - eng PT - Journal Article PL - New Zealand TA - Clin Drug Investig JT - Clinical drug investigation JID - 9504817 RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Adipose Tissue/*drug effects MH - Diabetes Mellitus, Type 2/*drug therapy MH - Drug Therapy, Combination MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Male MH - Middle Aged MH - Retrospective Studies MH - *Sodium-Glucose Transporter 2 Inhibitors PMC - PMC5762773 COIS- FUNDING: The authors received no specific financial support for this study. CONFLICT OF INTEREST: HJ. has received honoraria from Novo Nordisk, Sanofi, AstraZeneca Pharmaceuticals, Astellas Pharma, Boehringer Ingelheim, Daiichi-Sankyo, Eli Lilly, Takeda, and Novartis Pharmaceuticals. S.S. has received honoraria from MSD, AstraZeneca Pharmaceuticals, Itamar Medical, Ono Pharmaceutical, and Novo Nordisk. There are no other potential conflicts of interest relevant to this article. ETHICAL STANDARDS: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. The Human Ethics Review Committee of Jinnouchi Hospital approved the study protocol. The protocol approval number of this study is 2016-8-3 in our institution. Informed consent or a substitute for it was obtained from all patients included in the study. EDAT- 2017/11/04 06:00 MHDA- 2018/06/21 06:00 PMCR- 2017/11/02 CRDT- 2017/11/04 06:00 PHST- 2017/11/04 06:00 [pubmed] PHST- 2018/06/21 06:00 [medline] PHST- 2017/11/04 06:00 [entrez] PHST- 2017/11/02 00:00 [pmc-release] AID - 10.1007/s40261-017-0580-6 [pii] AID - 580 [pii] AID - 10.1007/s40261-017-0580-6 [doi] PST - ppublish SO - Clin Drug Investig. 2018 Jan;38(1):19-27. doi: 10.1007/s40261-017-0580-6.