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Dapagliflozin increases the lean-to total mass ratio in type 2 diabetes mellitus

Authors
  • Wolf, Vaneza Lira W.1
  • Breder, Ikaro1
  • de Carvalho, Luiz Sérgio F.1, 2
  • Soares, Alexandre A. S.3
  • Cintra, Riobaldo M.1
  • Barreto, Joaquim1
  • Munhoz, Daniel B.1
  • Kimura-Medorima, Sheila T.1
  • Nadruz, Wilson3
  • Guerra-Júnior, Gil4
  • Quinaglia, Thiago1
  • Muscelli, Elza1
  • Sposito, Andrei C.1
  • 1 State University of Campinas (Unicamp), Campinas, SP, Brazil , Campinas (Brazil)
  • 2 Directory of Clinical Research and Innovation, Institute for Strategic Management in Healthcare (IGESDF), Brasília, DF, Brazil , Brasília (Brazil)
  • 3 University of Brasilia Medical School, Brasilia, DF, Brazil , Brasilia (Brazil)
  • 4 University of Campinas, Campinas, São Paulo, Brazil , Campinas (Brazil)
Type
Published Article
Journal
Nutrition & Diabetes
Publisher
Nature Publishing Group UK
Publication Date
Jun 12, 2021
Volume
11
Issue
1
Identifiers
DOI: 10.1038/s41387-021-00160-5
Source
Springer Nature
Disciplines
  • brief-communication
License
Green

Abstract

We compared the effect of dapagliflozin versus glibenclamide on the ratio of lean-to total mass in patients with type 2 diabetes mellitus, carotid subclinical atherosclerosis, HbA1c 7.0–9.0% and 40–70 years-old. Ninety-eight patients (61% male; mean age 57 ± 7 years) were randomized into dapagliflozin 10 mg/day or glibenclamide 5 mg/day on top of metformin. Body composition was measured by Dual Energy X-Ray at randomization and after 12 weeks of treatment. Glycemic control was equivalent in both groups. Dapagliflozin decreased total body mass (−2741 g [95% CI: −3360 to 1945]; p < 0.001) and lean mass (−347 g [95% CI: −761 to −106]; p < 0.001), while glibenclamide increased total body mass (1060 g [95% CI: 140 to 1836]; p < 0.001) and lean mass (929 g [95% CI: 575 to 1283]; p < 0.001) for the differences between arms. The lean-to-total mass ratio increased by 1.2% in the dapagliflozin group and 0,018% in the glibenclamide group (p < 0.001). Dapagliflozin reduced the risk of a negative balance in the lean-to total mass ratio [OR: 0.16 (95% CI: 0.05 to 0.45); p < 0.001] even after adjustment for baseline lean-to total mass ratio, waist circumference, HOMAIR, HbA1c, mean of the two hands handgrip strength and gait speed [OR: 0.13 (95% CI: 0.03–0.57); p < 0.007]. In conclusion, under equivalent glycemic control, dapagliflozin reduced total body mass but increased the ratio of lean-to-total mass when compared with glibenclamide.

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