The effect of SGLT-2 inhibitors on cardiorespiratory fitness capacity: A systematic review and meta-analysis
Abstract
Objective: The study aimed to evaluate the effect of sodium-glucose transporter 2 (SGLT-2) inhibitors on various parameters of exercise capacity and provide an evidence-based basis for type 2 diabetes mellitus (T2DM) combined with heart failure (HF) patients or HF patients without T2DM who use SGLT-2 inhibitors to improve cardiorespiratory fitness (CRF). Methods: According to the participant, intervention, comparison, and outcome (PICO) elements, the effects of SGLT-2 inhibitor administration on VO2 or VO2peak were researched in this study. Weighted mean difference (WMD) and 95% confidence intervals (CIs) were calculated (random-effects model). Heterogeneity was assessed by the I2 test. Results: Six studies were included according to the eligibility criteria: four were RCTs, and two were non-RCTs. Compared with the control group, the merge results of RCTs showed that SGLT-2 inhibitors could significantly increase the VO2peak (WMD, 2.02 ml kg-1 min-1, 95% CI: 0.68-3.37, and p = 0.03; I2 = 0% and p = 0.40) and VAT (WMD, 1.57 ml kg-1 min-1, 95% CI: 0.06-3.07, and p = 0.04; I2 = 0% and p = 0.52) of the obese population, patients with T2DM, and chronic HF patients with or without T2DM. Subgroup analysis showed that SGLT-2 inhibitors improved the VO2peak in non-HF patients (WMD, 3.57 ml kg-1 min-1, 95% CI: 0.87-6.26, and p = 0.009; I2 = 4% and p = 0.31) more than in HF patients (WMD, 1.46 ml kg-1 min-1, 95% CI: -0.13-3.04, and p = 0.07; I2 = 0% and p = 0.81). Moreover, the merge…
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