Budoff Matthew J, Wilding John P H
Division of Cardiology, Los Angeles Biomedical Research Institute, Torrance, CA, USA.
Obesity and Endocrinology Clinical Research, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
Int J Clin Pract. 2017 May;71(5). doi: 10.1111/ijcp.12948.
Cardiovascular disease is the most common cause of morbidity and mortality among people with type 2 diabetes mellitus (T2DM). The main contributors to cardiovascular risk in T2DM are chronic hyperglycaemia, reduced insulin sensitivity, hypertension and dyslipidaemia. Other cardiovascular risk factors include obesity and visceral adiposity, increased arterial stiffness and renal dysfunction. Results from clinical trials, including a long-term cardiovascular outcome study, have shown that sodium glucose co-transporter 2 (SGLT2) inhibitors can provide multiple cardiometabolic benefits beyond glycaemic control including inducing mild osmotic diuresis, natriuresis and weight loss. This review article describes the effects of canagliflozin on cardiovascular risk factors based on results from its clinical development programme.
This review is based on structured searches to identify literature related to the effects of canagliflozin on cardiovascular risk factors in patients with T2DM.
Canagliflozin treatment has been shown to provide glycaemic improvements as well as reductions in blood pressure and body weight across a broad range of patients with T2DM, including those with elevated cardiovascular risk. Other observed effects of canagliflozin that may contribute to improved cardiometabolic outcomes include reduction in uric acid levels, decreased albuminuria and increases in serum magnesium. Results of ongoing long-term cardiovascular outcomes studies of canagliflozin are expected to provide additional evidence on the cardiometabolic effects of canagliflozin treatment.
心血管疾病是2型糖尿病(T2DM)患者发病和死亡的最常见原因。T2DM心血管风险的主要促成因素包括慢性高血糖、胰岛素敏感性降低、高血压和血脂异常。其他心血管危险因素包括肥胖和内脏脂肪过多、动脉僵硬度增加和肾功能不全。包括一项长期心血管结局研究在内的临床试验结果表明,钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂除了控制血糖外,还能带来多种心脏代谢益处,包括诱导轻度渗透性利尿、利钠和体重减轻。这篇综述文章根据卡格列净临床开发项目的结果,描述了其对心血管危险因素的影响。
本综述基于结构化检索,以识别与卡格列净对T2DM患者心血管危险因素影响相关的文献。
已证明卡格列净治疗可改善血糖,并降低广泛T2DM患者(包括心血管风险升高者)的血压和体重。卡格列净其他可能有助于改善心脏代谢结局的观察到的效应包括尿酸水平降低、蛋白尿减少和血清镁增加。卡格列净正在进行的长期心血管结局研究结果预计将为卡格列净治疗的心脏代谢效应提供更多证据。