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      KCI등재 SCOPUS SCIE

      A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans

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      https://www.riss.kr/link?id=A106374173

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      다국어 초록 (Multilingual Abstract)

      Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to fat mass (FM). Given the importance of skeletal muscle and lean body mass (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting theeffects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associatedwith both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In overhalf of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistentwith diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently,the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategiesto preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.
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      Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glu...

      Weight loss is an important goal in the management of several chronic conditions, including type 2 diabetes mellitus, and pharmacological therapies that aid weight loss are appealing. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is) are novel glucose-lowering therapies that have been shown to induce clinically significant reductions in body weight. However, this weight loss may not be attributed solely to fat mass (FM). Given the importance of skeletal muscle and lean body mass (LBM) on cardio-metabolic health and physical function, we reviewed the available literature reporting theeffects of GLP-1RAs and SGLT2is on body composition. Results demonstrate that, in most circumstances, the weight loss associatedwith both therapies predominantly comprises a reduction in FM, although significant heterogeneity exists between studies. In overhalf of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistentwith diet-induced weight loss and bariatric surgery. No clear differences existed between GLP-1RAs and SGLT2is. Consequently,the loss of LBM and skeletal muscle associated with weight loss induced by GLP-1RAs and SGLT2is warrants attention. Strategiesto preserve skeletal muscle and improve physical function, for example through structured exercise, are of great importance.

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      참고문헌 (Reference)

      1 Lundkvist P, "glycaemia and blood pressure over 1 year" 19 : 1276-1288, 2017

      2 Van Gaal L, "Weight management in type 2 diabetes : current and emerging approaches to treatment" 38 : 1161-1172, 2015

      3 Villareal DT, "Weight loss, exercise, or both and physical function in obese older adults" 364 : 1218-1229, 2011

      4 Jendle J, "Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue" 11 : 1163-1172, 2009

      5 Heymsfield SB, "Weight loss composition is one-fourth fat-free mass : a critical review and critique of this widely cited rule" 15 : 310-321, 2014

      6 Sayer AA, "Type 2 diabetes, muscle strength, and impaired physical function: the tip of the iceberg?" 28 : 2541-2542, 2005

      7 Rondanelli M, "Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus" 10 : 407-413, 2016

      8 Matsuba R, "Tofogliflozin decreases body fat mass and improves peripheral insulin resistance" 20 : 1311-1315, 2018

      9 Kinoshita T, "There is a close association between the recovery of liver injury and glycemic control after SGLT2 inhibitor treatment in Japanese subjects with type 2 diabetes : a retrospective clinical study" 9 : 1569-1580, 2018

      10 Harder H, "The effect of liraglutide, a long-acting glucagon-like peptide 1 derivative, on glycemic control, body composition, and 24-h energy expenditure in patients with type 2 diabetes" 27 : 1915-1921, 2004

      1 Lundkvist P, "glycaemia and blood pressure over 1 year" 19 : 1276-1288, 2017

      2 Van Gaal L, "Weight management in type 2 diabetes : current and emerging approaches to treatment" 38 : 1161-1172, 2015

      3 Villareal DT, "Weight loss, exercise, or both and physical function in obese older adults" 364 : 1218-1229, 2011

      4 Jendle J, "Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue" 11 : 1163-1172, 2009

      5 Heymsfield SB, "Weight loss composition is one-fourth fat-free mass : a critical review and critique of this widely cited rule" 15 : 310-321, 2014

      6 Sayer AA, "Type 2 diabetes, muscle strength, and impaired physical function: the tip of the iceberg?" 28 : 2541-2542, 2005

      7 Rondanelli M, "Twenty-four-week effects of liraglutide on body composition, adherence to appetite, and lipid profile in overweight and obese patients with type 2 diabetes mellitus" 10 : 407-413, 2016

      8 Matsuba R, "Tofogliflozin decreases body fat mass and improves peripheral insulin resistance" 20 : 1311-1315, 2018

      9 Kinoshita T, "There is a close association between the recovery of liver injury and glycemic control after SGLT2 inhibitor treatment in Japanese subjects with type 2 diabetes : a retrospective clinical study" 9 : 1569-1580, 2018

      10 Harder H, "The effect of liraglutide, a long-acting glucagon-like peptide 1 derivative, on glycemic control, body composition, and 24-h energy expenditure in patients with type 2 diabetes" 27 : 1915-1921, 2004

      11 Seino Y, "Sodium-glucose cotransporter-2 inhibitor luseogli flozin added to glucagon-like peptide 1 receptor agonist liraglutide improves glycemic control with bodyweight and fat mass reductions in Japanese patients with type 2 diabetes: a 52-week, open-label, single-arm study" 9 : 332-340, 2018

      12 Sasaki T, "Sodium-glucose cotransporter 2 inhibitor-induced changes in body composition and simultaneous changes in metabolic profile : 52-week prospective LIGHT(Luseogliflozin : the Components of Weight Loss in Japanese Patients with Type 2 Diabetes Mellitus)Study" 10 : 108-117, 2019

      13 DeFronzo RA, "Skeletal muscle insulin resistance is the primary defect in type 2 diabetes" 32 (32): S157-S163, 2009

      14 Astrup A, "Safety, tolerability and sustained weight loss over 2 years with the once-daily human GLP-1 analog, liraglutide" 36 : 843-854, 2012

      15 Zelniker TA, "SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes : a systematic review and meta-analysis of cardiovascular outcome trials" 393 : 31-39, 2019

      16 Lean ME, "Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial" 391 : 541-551, 2018

      17 Buckinx F, "Pitfalls in the measurement of muscle mass : a need for a reference standard" 9 : 269-278, 2018

      18 Cohen S, "Muscle wasting in disease : molecular mechanisms and promising therapies" 14 : 58-74, 2015

      19 Johannsen DL, "Metabolic slowing with massive weight loss despite preservation of fat-free mass" 97 : 2489-2496, 2012

      20 Bouchi R, "Luseogliflozin reduces epicardial fat accumulation in patients with type 2 diabetes : a pilot study" 16 : 32-, 2017

      21 Weiss EP, "Lower extremity muscle size and strength and aerobic capacity decrease with caloric restriction but not with exercise-induced weight loss" 102 : 634-640, 2007

      22 Janssen I, "Low relative skeletal muscle mass(sarcopenia)in older persons is associated with functional impairment and physical disability" 50 : 889-896, 2002

      23 Delmonico MJ, "Longitudinal study of muscle strength, quality, and adipose tissue infiltration" 90 : 1579-1585, 2009

      24 McLeod M, "Live strong and prosper : the importance of skeletal muscle strength for healthy ageing" 17 : 497-510, 2016

      25 Perna S, "Liraglutide and obesity in elderly: efficacy in fat loss and safety in order to prevent sarcopenia. A perspective case series study" 28 : 1251-1257, 2016

      26 Schneider J, "Laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass lead to equal changes in body composition and energy metabolism 17 months postoperatively : a prospective randomized trial" 12 : 563-570, 2016

      27 Inoue H, "Ipragliflozin, a sodium-glucose cotransporter 2 inhibitor, reduces bodyweight and fat mass, but not muscle mass, in Japanese type 2 diabetes patients treated with insulin: a randomized clinical trial" 10 : 1012-1021, 2019

      28 Ohta A, "Ipragliflozin, a sodium glucose co-transporter 2 inhibitor, reduces intrahepatic lipid content and abdominal visceral fat volume in patients with type 2 diabetes" 18 : 1433-1438, 2017

      29 Yamamoto C, "Ipragliflozin effectively reduced visceral fat in Japanese patients with type 2 diabetes under adequate diet therapy" 63 : 589-596, 2016

      30 Miyake T, "Ipragliflozin ameliorates liver damage in non-alcoholic fatty liver disease" 13 : 402-409, 2018

      31 Santanasto AJ, "Impact of weight loss on physical function with changes in strength, muscle mass, and muscle fat infiltration in overweight to moderately obese older adults: a randomized clinical trial" 2011 : 516576-, 2011

      32 Morley JE, "Frailty, sarcopenia and diabetes" 15 : 853-859, 2014

      33 Saum KU, "Frailty prevalence and 10-year survival in community-dwelling older adults : results from the ESTHER cohort study" 29 : 171-179, 2014

      34 Morley JE, "Frailty : diagnosis and management" 15 : 667-670, 2011

      35 Davidson LE, "Fat-free mass and skeletal muscle mass five years after bariatric surgery" 26 : 1130-1136, 2018

      36 Beavers KM, "Fat mass loss predicts gain in physical function with intentional weight loss in older adults" 68 : 80-86, 2013

      37 Bunck MC, "Exenatide affects circulating cardiovascular risk biomarkers independently of changes in body composition" 33 : 1734-1737, 2010

      38 Shimizu M, "Evaluation of the effects of dapagliflozin, a sodium-glucose co-transporter-2 inhibitor, on hepatic steatosis and fibrosis using transient elastography in patients with type 2 diabetes and non-alcoholic fatty liver disease" 21 : 285-292, 2019

      39 Iwahashi Y, "Evaluation of metabolic parameters and body composition in Japanese patients with type 2 diabetes mellitus who were administered tofogliflozin for 48 weeks" 8 : 205-211, 2016

      40 Osonoi T, "Efficacy of ipragliflozin as monotherapy or as add-on therapy with other oral antidiabetic medications for treating type 2 diabetes in Japanese patients with inadequate glycemic control : a subgroup analysis based on patient characteristics" 9 : 341-353, 2018

      41 Iemitsu K, "Efficacy and safety of ipragliflozin in patients with type 2 diabetes : ASSIGN-K study" 9 : 51-62, 2019

      42 Kato M, "Efficacy and safety of ipragliflozin in Japanese patients with type 2 diabetes receiving conventional therapy : clinical implication of the importance of exercise habits during treatment with ipragliflozin" 8 : 275-285, 2017

      43 Cefalu WT, "Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trial" 382 : 941-950, 2013

      44 Fadini GP, "Effects of the SGLT2 inhibitor dapagliflozin on HDL cholesterol, particle size, and cholesterol efflux capacity in patients with type 2 diabetes: a randomized placebo-controlled trial" 16 : 42-, 2017

      45 Kosugi R, "Effects of sodium-glucose cotransporter 2 inhibitor(dapagliflozin)on food intake and plasma fibroblast growth factor 21 levels in type 2 diabetes patients" 66 : 677-682, 2019

      46 Nicklas BJ, "Effects of resistance training with and without caloric restriction on physical function and mobility in overweight and obese older adults : a randomized controlled trial" 101 : 991-999, 2015

      47 Blundell J, "Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight in subjects with obesity" 19 : 1242-1251, 2017

      48 Magkos F, "Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity" 23 : 591-601, 2016

      49 Feng WH, "Effects of liraglutide, metformin and gliclazide on body composition in patients with both type 2 diabetes and non-alcoholic fatty liver disease: a randomized trial" 10 : 399-407, 2019

      50 Yin TT, "Effects of exenatide versus insulin glargine on body composition in overweight and obese T2DM patients : a randomized controlled trial" 15 : 67-, 2018

      51 Javed Z, "Effects of empagliflozin on metabolic parameters in polycystic ovary syndrome : a randomized controlled study" 90 : 805-813, 2019

      52 Tobita H, "Effects of dapagliflozin on body composition and liver tests in patients with nonalcoholic steatohepatitis associated with type 2 diabetes mellitus: a prospective, open-label, uncontrolled study" 87 : 13-19, 2017

      53 Blonde L, "Effects of canagliflozin on body weight and body composition in patients with type 2 diabetes over 104 weeks" 128 : 371-380, 2016

      54 Inoue M, "Effects of canagliflozin on body composition and hepatic fat content in type 2 diabetes patients with non-alcoholic fatty liver disease" 10 : 1004-1011, 2019

      55 홍주영, "Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients" 대한내분비학회 31 (31): 80-85, 2016

      56 Kamei S, "Effect of tofogliflozin on body composition and glycemic control in Japanese subjects with type 2 diabetes mellitus" 2018 : 6470137-, 2018

      57 Seko Y, "Effect of sodium glucose cotransporter 2 inhibitor on liver function tests in Japanese patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus" 47 : 1072-1078, 2017

      58 Arase Y, "Effect of sodium glucose co-transporter 2 inhibitors on liver fat mass and body composition in patients with nonalcoholic fatty liver disease and type 2 diabetes mellitus" 39 : 631-641, 2019

      59 Frossing S, "Effect of liraglutide on ectopic fat in polycystic ovary syndrome : a randomized clinical trial" 20 : 215-218, 2018

      60 Koike Y, "Effect of canagliflozin on the overall clinical state including insulin resistance in Japanese patients with type 2 diabetes mellitus" 149 : 140-146, 2019

      61 Ishoy PL, "Effect of GLP-1 receptor agonist treatment on body weight in obese antipsychotic-treated patients with schizophrenia: a randomized, placebo-controlled trial" 19 : 162-171, 2017

      62 Seko Y, "Effect of 12-week dulaglutide therapy in Japanese patients with biopsy-proven non-alcoholic fatty liver disease and type 2 diabetes mellitus" 47 : 1206-1211, 2017

      63 Gerstein HC, "Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomized placebo-controlled trial" 394 : 121-130, 2019

      64 Brozek J, "Densitometric analysis of body composition : revision of some quantitative assumptions" 110 : 113-140, 1963

      65 Park SW, "Decreased muscle strength and quality in older adults with type 2 diabetes: the health, aging, and body composition study" 55 : 1813-1818, 2006

      66 Sugiyama S, "Dapagliflozin reduces fat mass without affecting muscle mass in type 2 diabetes" 25 : 467-476, 2018

      67 Bolinder J, "Dapagliflozin maintains glycaemic control while reducing weight and body fat mass over 2 years in patients with type 2 diabetes mellitus inadequately controlled on metformin" 16 : 159-169, 2014

      68 Zelniker TA, "Comparison of the effects of glucagon-like peptide receptor agonists and sodium-glucose cotransporter 2 inhibitors for prevention of major adverse cardiovascular and renal outcomes in type 2 diabetes mellitus" 139 : 2022-2031, 2019

      69 Ridderstrale M, "Comparison of empagliflozin and glimepiride as add-on to metformin in patients with type 2 diabetes: a 104-week randomised, active-controlled, double-blind, phase 3 trial" 2 : 691-700, 2014

      70 Li CJ, "Changes in liraglutide-induced body composition are related to modifications in plasma cardiac natriuretic peptides levels in obese type 2 diabetic patients" 13 : 36-, 2014

      71 Chaston TB, "Changes in fat-free mass during significant weight loss : a systematic review" 31 : 743-750, 2007

      72 Perkovic V, "Canagliflozin and renal outcomes in type 2 diabetes and nephropathy" 380 : 2295-2306, 2019

      73 Fields DA, "Body-composition assessment via air-displacement plethysmography in adults and children : a review" 75 : 453-467, 2002

      74 Dube MC, "Beyond glycaemic control: a cross-over, double-blinded, 24-week intervention with liraglutide in type 1 diabetes" 20 : 178-184, 2018

      75 Sjostrom L, "Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications" 311 : 2297-2304, 2014

      76 Sinclair AJ, "An international position statement on the management of frailty in diabetes mellitus : summary of recommendations 2017" 7 : 10-20, 2018

      77 Bradley DP, "Alterations in energy balance following exenatide administration" 37 : 893-899, 2012

      78 Pollock C, "Albuminuria-lowering effect of dapagliflozin alone and in combination with saxagliptin and effect of dapagliflozin and saxagliptin on glycaemic control in patients with type 2 diabetes and chronic kidney disease (DELIGHT): a randomised, double-blind, placebo-controlled trial" 7 : 429-441, 2019

      79 Davies MJ, "A consensus report by the American Diabetes Association(ADA)and the European Association for the Study of Diabetes(EASD)" 61 : 2461-2498, 2018

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