Longitudinal Improvement in Waist-to-Height Ratio During SGLT-2 Inhibitor Therapy Within a Structured Multidisciplinary Care Model: A Prospective Real-World Cohort Study
- 1Department of Internal Medicine, University of Health Sciences Sultan 2, Abdülhamid Han Training and Research Hospital, Istanbul 34668, Turkey
- 2Department of Nephrology, University of Health Sciences Sultan 2, Abdülhamid Han Training and Research Hospital, Istanbul 34668, Turkey
Abstract
Background/Objectives: The waist-to-height ratio (WHtR) is a sensitive marker of central obesity. This study examined the longitudinal trajectory of WHtR in patients with type 2 diabetes (T2DM) initiating sodium–glucose cotransporter-2 (SGLT-2) inhibitor therapy within a structured, physician-supported multidisciplinary care model. Methods: This prospective observational cohort study included 140 adults with T2DM initiating SGLT-2 inhibitor therapy, followed at a diabetes outpatient clinic by a physician, diabetes nurse, and dietitian. Anthropometric and bioimpedance measurements, physical activity, and dietary adherence were assessed at baseline, month 3, and month 6. Longitudinal changes were analyzed by repeated-measures ANOVA with Bonferroni-corrected post hoc tests, and linear mixed-effects models assessed factors associated with WHtR over time. Results: Mean age was 54.08 ± 11.40 years, and 49.3% of participants were female. WHtR decreased from 0.665 ± 0.101 at baseline to 0.635 ± 0.096 at month 3 and 0.629 ± 0.096 at month 6 (p < 0.001). Body weight (87.68 ± 18.68 to 84.18 ± 17.01 kg), BMI, and waist, hip, and neck circumferences all decreased significantly (p < 0.001), while physical activity and Mediterranean diet adherence increased (p < 0.001). In the mixed-effects model, WHtR remained significantly lower at month 3 (β = −0.029) and month 6 (β = −0.035) than at baseline (both p < 0.001) after multivariable adjustment. Female sex was associated with a higher WHtR level (β = 0.095, p < 0.001), whereas the reduction in WHtR did not differ by sex (p = 0.167). Conclusions: Initiating SGLT-2 inhibitor therapy within a structured multidisciplinary diabetes care model was associated with a significant reduction in central adiposity over six months, most notably reflected by WHtR. These findings support WHtR as a simple tool for monitoring treatment response in patients with T2DM; as mean WHtR remained above 0.5, it may also help identify patients requiring further intervention.
Related
- Emotional Improvement Despite General Clinical Deterioration During Multidisciplinary Rehabilitation in Stiff Person Syndrome: A Longitudinal Case Report
- Association of a structured nutrition-centred multidisciplinary supportive-care program with treatment tolerance and clinical outcomes in patients undergoing precision radiotherapy for head and neck cancer: a prospective cohort study
- Multidisciplinary attitudes towards LLM-structured oncologic CT reports: a prospective fixed-sequence questionnaire study.
- Changes in parent-rated attention-deficit/hyperactivity disorder symptom scores and sleep parameters during individualized multidisciplinary clinical management in children with comorbid obstructive sleep apnea: a prospective cohort study in Vietnam
- Heterogeneity in nerve recovery patterns despite symptomatic improvement in paclitaxel-induced neuropathy : A longitudinal analysis
BibTeX
@article{kılıc2026longitudinal,
title = {{Longitudinal Improvement in Waist-to-Height Ratio During SGLT-2 Inhibitor Therapy Within a Structured Multidisciplinary Care Model: A Prospective Real-World Cohort Study}},
author = {Süleyman Kılıç and Elif Yıldırım Ayaz and Aziz Kaan Türkoğlu and Musa Salmanoğlu and Abdülhamid Arslan and Memnune Sena Ulu},
journal = {Metabolites},
year = {2026},
month = oct,
doi = {10.3390/metabo16110811},
url = {https://www.mdpi.com/2218-1989/16/11/811},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Longitudinal Improvement in Waist-to-Height Ratio During SGLT-2 Inhibitor Therapy Within a Structured Multidisciplinary Care Model: A Prospective Real-World Cohort Study
AU - Süleyman Kılıç
AU - Elif Yıldırım Ayaz
AU - Aziz Kaan Türkoğlu
AU - Musa Salmanoğlu
AU - Abdülhamid Arslan
AU - Memnune Sena Ulu
PY - 2026
DA - 2026/10/26
JO - Metabolites
DO - 10.3390/metabo16110811
UR - https://www.mdpi.com/2218-1989/16/11/811
AB - Background/Objectives: The waist-to-height ratio (WHtR) is a sensitive marker of central obesity. This study examined the longitudinal trajectory of WHtR in patients with type 2 diabetes (T2DM) initiating sodium–glucose cotransporter-2 (SGLT-2) inhibitor therapy within a structured, physician-supported multidisciplinary care model. Methods: This prospective observational cohort study included 140 adults with T2DM initiating SGLT-2 inhibitor therapy, followed at a diabetes outpatient clinic by a physician, diabetes nurse, and dietitian. Anthropometric and bioimpedance measurements, physical activity, and dietary adherence were assessed at baseline, month 3, and month 6. Longitudinal changes were analyzed by repeated-measures ANOVA with Bonferroni-corrected post hoc tests, and linear mixed-effects models assessed factors associated with WHtR over time. Results: Mean age was 54.08 ± 11.40 years, and 49.3% of participants were female. WHtR decreased from 0.665 ± 0.101 at baseline to 0.635 ± 0.096 at month 3 and 0.629 ± 0.096 at month 6 (p < 0.001). Body weight (87.68 ± 18.68 to 84.18 ± 17.01 kg), BMI, and waist, hip, and neck circumferences all decreased significantly (p < 0.001), while physical activity and Mediterranean diet adherence increased (p < 0.001). In the mixed-effects model, WHtR remained significantly lower at month 3 (β = −0.029) and month 6 (β = −0.035) than at baseline (both p < 0.001) after multivariable adjustment. Female sex was associated with a higher WHtR level (β = 0.095, p < 0.001), whereas the reduction in WHtR did not differ by sex (p = 0.167). Conclusions: Initiating SGLT-2 inhibitor therapy within a structured multidisciplinary diabetes care model was associated with a significant reduction in central adiposity over six months, most notably reflected by WHtR. These findings support WHtR as a simple tool for monitoring treatment response in patients with T2DM; as mean WHtR remained above 0.5, it may also help identify patients requiring further intervention.
SN - 2218-1989
ER -