Correlation Between Changes in the Serum Magnesium Concentration and Visceral Fat Volume in Patients With Type 2 Diabetes Receiving Luseogliflozin: A Sub-Analysis of Data From the LIGHT Study

Background: Sodium-glucose cotransporter 2 (SGLT-2) inhibitors have been reported to more effectively suppress cardiovascular events (CVEs) in patients with type 2 diabetes. The underlying mechanism, however, remains unknown. SGLT-2 inhibitors have the unique beneficial effect of ameliorating hypomagnesemia, which is a well-known independent risk factor for CVE. However, the mechanism by which SGLT-2 inhibitors increase the serum magnesium (Mg) levels also remains unknown. We hypothesized that SGLT-2 inhibitor-induced visceral fat loss might also be correlated with the serum Mg levels. Methods: We conducted a sub-analysis of the data of 31 patients with type 2 diabetes who were treated with luseogliflozin in the LIGHT study. The correlations between changes in the serum Mg concentration (Delta Mg) and the baseline patient characteristics/changes in the values of clinical parameters at 24 weeks were analyzed by multiple regression analysis. Results: The Delta Mg was significantly associated with the baseline serum Mg concentration (beta = -0.47, 95% confidence interval (CI): -0.84 - -0.13; P = 0.01) and Delta visceral fat volume (VFV) (beta = -0.33, -0.59 - -0.09; P = 0.03). Conclusions: We found that elevation of serum Mg concentrations after SGLT-2 inhibitor treatment was associated with two factors; low serum Mg concentrations before the start of treatment and decrease in the VFV after treatment. J Endocrinol Metab. 2021;11(2):35-41 doi: https://doi.org/10.14740/jem738