Differential effect of canagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, on slow and fast skeletal muscles from nondiabetic mice

Biochem J. 2022 Feb 11;479(3):425-444. doi: 10.1042/BCJ20210700.

Abstract

There has been a concern that sodium-glucose cotransporter 2 (SGLT2) inhibitors could reduce skeletal muscle mass and function. Here, we examine the effect of canagliflozin (CANA), an SGLT2 inhibitor, on slow and fast muscles from nondiabetic C57BL/6J mice. In this study, mice were fed with or without CANA under ad libitum feeding, and then evaluated for metabolic valuables as well as slow and fast muscle mass and function. We also examined the effect of CANA on gene expressions and metabolites in slow and fast muscles. During SGLT2 inhibition, fast muscle function is increased, as accompanied by increased food intake, whereas slow muscle function is unaffected, although slow and fast muscle mass is maintained. When the amount of food in CANA-treated mice is adjusted to that in vehicle-treated mice, fast muscle mass and function are reduced, but slow muscle was unaffected during SGLT2 inhibition. In metabolome analysis, glycolytic metabolites and ATP are increased in fast muscle, whereas glycolytic metabolites are reduced but ATP is maintained in slow muscle during SGLT2 inhibition. Amino acids and free fatty acids are increased in slow muscle, but unchanged in fast muscle during SGLT2 inhibition. The metabolic effects on slow and fast muscles are exaggerated when food intake is restricted. This study demonstrates the differential effects of an SGLT2 inhibitor on slow and fast muscles independent of impaired glucose metabolism, thereby providing new insights into how they should be used in patients with diabetes, who are at a high risk of sarcopenia.

Keywords: SGLT2 inhibitor; fast muscle; metabolomics; skeletal muscle; slow muscle.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Adenylate Kinase / biosynthesis
  • Adenylate Kinase / genetics
  • Adipose Tissue, White / drug effects
  • Amino Acids / metabolism
  • Animals
  • Body Weight / drug effects
  • Canagliflozin / pharmacology
  • Eating / drug effects
  • Fatty Acids, Nonesterified / metabolism
  • Gene Expression Regulation / drug effects
  • Gene Ontology
  • Glycolysis
  • Hand Strength
  • Liver / drug effects
  • Male
  • Metabolome / drug effects
  • Mice
  • Mice, Inbred C57BL
  • Muscle Fibers, Fast-Twitch / drug effects*
  • Muscle Fibers, Fast-Twitch / metabolism
  • Muscle Fibers, Slow-Twitch / drug effects*
  • Muscle, Skeletal / drug effects
  • Organ Size / drug effects
  • Phosphatidylinositol 3-Kinases / metabolism
  • Proto-Oncogene Proteins c-akt / metabolism
  • Sodium-Glucose Transporter 2 / physiology
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology
  • TOR Serine-Threonine Kinases / biosynthesis
  • TOR Serine-Threonine Kinases / genetics

Substances

  • Amino Acids
  • Fatty Acids, Nonesterified
  • Slc5a2 protein, mouse
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • Canagliflozin
  • Adenosine Triphosphate
  • mTOR protein, mouse
  • Proto-Oncogene Proteins c-akt
  • TOR Serine-Threonine Kinases
  • Adenylate Kinase