{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:25:08Z","timestamp":1793053508862,"version":"4.5.0"},"reference-count":63,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Boehringer Ingelheim\u2014Lilly Alliance Spain","award":["CIF-A-08006470"],"award-info":[{"award-number":["CIF-A-08006470"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Sodium glucose cotransporter-2 (SGLT-2) inhibitors have emerged as integral therapeutic tools in the management of patients with cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome. In addition to their well-documented effects on lowering glucose levels and cardiovascular- and reno-protective actions, SGLT-2 inhibitors, through a reduction in body weight (BW), generate changes in the body composition and volume status that have not been clearly studied. Materials and\u00a0Methods: This retrospective, observational longitudinal cohort, single-center study analyzed and compared body composition and fluid status measured by bioelectrical impedance analysis (BIA) from weeks 0 to 12 after the initiation of the cardiac rehabilitation (CR) program for coronary artery disease and heart failure in 59 patients who started treatment with SGLT-2 inhibitors (SGLT-2iG) and 112 patients without SGLT-2 inhibitors (non-SGLT-2iG). Results: Changes between the baseline and week 12 in the SGLT-2iG and non-SGLT-2iG were \u22120.3 L (p = 0.003) and \u22120.03 L (p = 0.82) in extracellular water (ECW) (p = 0.05), \u22120.39 L (p &lt; 0.001) and \u22120.14 L (p = 0.33) in intracellular water (ICW) (p = 0.12), \u22120.69 (p &lt; 0.001) and \u22120.16 (p = 0.52) in total body water (TBW) (p = 0.08), and \u22120.01 (p = 0.37) and \u22120.001 (p = 0.25) in the ECW\/TBW ratio, respectively. After 3 months of exercise therapy in the CR program, patients in the SGLT-2iG showed a greater decrease than the non-SGLT-2iG in weight (\u22121.34 kg, p &lt; 0.001 vs. \u22120.99, p = 0.02), body mass index (BMI) (\u22120.45 kg\/m2, p &lt; 0.001 vs. \u22120.38, p = 0.004), arm circumference (\u22120.57 cm, p = 0.008 vs. \u22120.12 cm, p = 0.21), waist circumference (\u22121.5 cm, p = 0.04 vs. \u22120.11 cm, p = 0.83), systolic blood pressure (SBP) (\u22128.9 mmHg, p = 0.049 vs. \u22124.19, p = 0.08), and diastolic blood pressure (DBP) (\u22125.15, p = 0.03 vs. \u22122.85, p = 0.01). The bioelectrical impedance analysis (BIA) revealed a significant decrease in body fat mass (BFM) and visceral fat area, without a loss of lean body mass (LBM) or skeletal muscle mass in the SGLT-2iG. Conclusions: SGLT-2 inhibitors exert beneficial effects on body compartments and volume status. Although they induce modest weight loss, this appears to be mainly directed at ECW, BFM, and visceral fat, without a loss of LBM nor skeletal muscle mass, which could contribute to the observed CKM benefits.<\/jats:p>","DOI":"10.3390\/medicina60122096","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T04:33:29Z","timestamp":1734928409000},"page":"2096","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Body Composition and Fluid Status in Cardiovascular Rehabilitation Patients with Coronary Artery Disease and Heart Failure"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9346-2279","authenticated-orcid":false,"given":"Jos\u00e9 C.","family":"De La Flor","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"},{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"},{"name":"Health Sciences Doctoral Program, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blanca","family":"Coto Morales","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Basabe","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Rey Hernandez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Zamora Gonz\u00e1lez-Mari\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario General Villalba, 28400 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Rodr\u00edguez Tudero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"},{"name":"PhD in Surgery Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9871-0419","authenticated-orcid":false,"given":"Irwing","family":"Benites Flores","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Alberto Barton Thompson, Lima 07001, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Espinoza","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Peruana Cayetano Heredia University, Lima 15002, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6558-7231","authenticated-orcid":false,"given":"Michael","family":"Cieza Terrones","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Peruana Cayetano Heredia University, Lima 15002, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Secundino","family":"Cigarr\u00e1n Guldris","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Ribera Polusa, 27004 Lugo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Hern\u00e1ndez Vaquero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Central de la Defensa G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s12933-023-01937-x","article-title":"The cardio-renal-metabolic connection: A review of the evidence","volume":"22","author":"Marassi","year":"2023","journal-title":"Cardiovasc. 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