Effect of SGLT2 inhibitors on body composition, fluid status and renin-angiotensin-aldosterone system in type 2 diabetes: A prospective study using bioimpedance spectroscopy.

BackgroundSGLT2-inhibitors are potent antihyperglycemic drugs for patients with type 2 diabetes and have been shown to reduce body weight. However, it is unclear which body compartments are reduced and to what extent.MethodsIn this longitudinal observational study, we analyzed the body composition of 27 outpatients with type 2 diabetes mellitus during the first week and up to 6months after initiation of treatment with SGLT2-inhibitors (n=18 empagliflozin, n=9 dapagliflozin) using bioimpedance spectroscopy (BCM, Fresenius). Fluid status of hypertensive patients taking medication with hydrochlorothiazide (n=14) and healthy persons (n=16) were analyzed for comparison.ResultsAt 6months, HbA1c decreased by 0.8% (IQR 2.3; 0.4), body weight and BMI by 2.6kg (1.5; 9.3) and 0.9kg/m(2) (0.4; 3.3), respectively. Bioimpedance spectroscopy revealed significant decrease in adipose tissue mass and fat tissue index while lean tissue parameters remained stable. Overhydration (OH) and extracellular water (ECW) decreased by -0.5L/1.73m(2) (-0.1; -0.9) and -0.4 L/1.73m(2) (-0.1; -0.8) at day 3, respectively, and returned to the initial value after 3 and 6months. Plasma renin activity increased by 2.1-fold (0.5; 3.6) at 1month and returned to the initial level at month 3 and 6. Fluid status of patients with SGLT2 inhibitors after 6months showed no difference from that of hypertensive patients taking hydrochlorothiazide or healthy persons.ConclusionsBody weight reduction under the treatment with SGLT2-inhibitors is caused by reduction of adipose tissue mass and transient loss of extracellular fluid, which is accompanied by upregulation of renin-angiotensin-aldosterone system (RAAS). Permanent loss of extracellular water does not occur under SGLT2 inhibition

GEROS-ISS: GNSS Reflectometry, Radio Occultation and Scatterometry onboard the International Space Station

GEROS-ISS stands for GNSS REflectometry, radio occultation, and scatterometry onboard the International Space Station (ISS). It is a scientific experiment, successfully proposed to the European Space Agency in 2011. The experiment as the name indicates will be conducted on the ISS. The main focus of GEROS-ISS is the dedicated use of signals from the currently available Global Navigation Satellite Systems (GNSS) in L-band for remote sensing of the Earth with a focus to study climate change. Prime mission objectives are the determination of the altimetric sea surface height of the oceans and of the ocean surface mean square slope, which is related to sea roughness and wind speed. These geophysical parameters are derived using reflected GNSS signals (GNSS reflectometry, GNSS-R). Secondary mission goals include atmosphere/ionosphere sounding using refracted GNSS signals (radio occultation, GNSS-RO) and remote sensing of land surfaces using GNSS-R. The GEROS-ISS mission objectives and its design, the current status, and ongoing activities are reviewed and selected scientific and technical results of the GEROS-ISS preparation phase are described