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恩格列净可降低 2 型糖尿病患者的血压和尿酸:系统评价和荟萃分析。

Empagliflozin reduces blood pressure and uric acid in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

机构信息

Division of Hypertension, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, 471003, China.

Division of Endocrinology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, 471000, China.

出版信息

J Hum Hypertens. 2019 Apr;33(4):327-339. doi: 10.1038/s41371-018-0134-2. Epub 2018 Nov 15.


DOI:10.1038/s41371-018-0134-2
PMID:30443007
Abstract

The antidiabetic effect of empagliflozin in patients with type 2 diabetes mellitus has been explored in several trials. We performed this meta-analysis determining the effects of empagliflozin on blood pressure, uric acid, estimated glomerular filtration rate, blood lipids, blood glucose, and body weight in patients with type 2 diabetes mellitus. We searched three electronic databases (Pubmed, Web of Science, and Cochrane Central) for all published articles evaluating the effects of empagliflozin on blood glucose or blood pressure in subjects with type 2 diabetes mellitus. Total 5781 patients were included in 12 randomized controlled trials with a follow-up of 28 ± 22 weeks. Empagliflozin 10 or 25 mg reduced systolic and diastolic blood pressure, uric acid, hemoglobin A1c, fasting plasma glucose, and body weight in patients with type 2 diabetes mellitus (all p < 0.001). There were no differences for changes of estimated glomerular filtration rate between empagliflozin 10 or 25 mg and placebo in these patients (all p > 0.05). In conclusion, empagliflozin reduces systolic and diastolic blood pressure, uric acid, hemoglobin A1c, fasting plasma glucose, and body weight. These data suggest the beneficial effects of empagliflozin on these cardiovascular risk factors in patients with type 2 diabetes mellitus.

摘要

恩格列净在 2 型糖尿病患者中的降糖作用已在多项试验中得到了探索。我们进行了这项荟萃分析,旨在确定恩格列净对 2 型糖尿病患者的血压、尿酸、估算肾小球滤过率、血脂、血糖和体重的影响。我们在三个电子数据库(Pubmed、Web of Science 和 Cochrane Central)中搜索了所有评估恩格列净对 2 型糖尿病患者血糖或血压影响的已发表文章。共有 5781 名患者纳入了 12 项随机对照试验,随访时间为 28±22 周。恩格列净 10 或 25mg 可降低 2 型糖尿病患者的收缩压和舒张压、尿酸、糖化血红蛋白、空腹血糖和体重(均 p<0.001)。在这些患者中,恩格列净 10 或 25mg 与安慰剂相比,估算肾小球滤过率的变化无差异(均 p>0.05)。总之,恩格列净可降低收缩压和舒张压、尿酸、糖化血红蛋白、空腹血糖和体重。这些数据表明,恩格列净对 2 型糖尿病患者的这些心血管危险因素具有有益作用。

相似文献

[1]
Empagliflozin reduces blood pressure and uric acid in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

J Hum Hypertens. 2018-11-15

[2]
Pooled analysis of Phase III trials indicate contrasting influences of renal function on blood pressure, body weight, and HbA1c reductions with empagliflozin.

Kidney Int. 2017-8-30

[3]
How does empagliflozin improve arterial stiffness in patients with type 2 diabetes mellitus? Sub analysis of a clinical trial.

Cardiovasc Diabetol. 2019-3-29

[4]
A prospective randomized study comparing effects of empagliflozin to sitagliptin on cardiac fat accumulation, cardiac function, and cardiac metabolism in patients with early-stage type 2 diabetes: the ASSET study.

Cardiovasc Diabetol. 2021-2-2

[5]
Empagliflozin for Type 2 Diabetes Mellitus: An Overview of Phase 3 Clinical Trials.

Curr Diabetes Rev. 2017

[6]
Comparison of the clinical effect of empagliflozin on glycemic and non-glycemic parameters in Japanese patients with type 2 diabetes and cardiovascular disease treated with or without baseline metformin.

Cardiovasc Diabetol. 2021-7-31

[7]
Efficacy of dapagliflozin versus sitagliptin on cardiometabolic risk factors in Japanese patients with type 2 diabetes: a prospective, randomized study (DIVERSITY-CVR).

Cardiovasc Diabetol. 2020-1-7

[8]
Efficacy and safety of empagliflozin for type 2 diabetes: a systematic review and meta-analysis.

Diabetes Obes Metab. 2014-10

[9]
Improvement in Cardiovascular Outcomes With Empagliflozin Is Independent of Glycemic Control.

Circulation. 2018-10-23

[10]
Effect of Empagliflozin on Left Ventricular Mass in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease: The EMPA-HEART CardioLink-6 Randomized Clinical Trial.

Circulation. 2019-8-22

引用本文的文献

[1]
The effect of ertugliflozin in patients with nonalcoholic fatty liver disease associated with type 2 diabetes mellitus: A randomized controlled trial.

Medicine (Baltimore). 2024-11-8

[2]
The Uricosuric Effect of SGLT2 Inhibitors Is Maintained in the Long Term in Patients with Chronic Kidney Disease and Type 2 Diabetes Mellitus.

J Clin Med. 2024-2-27

[3]
Narrative literature review of antidiabetic drugs' effect on hyperuricemia: elaborating actual data and mechanisms.

Endocr Connect. 2024-5-10

[4]
The Association between Uric Acid and Metabolic Syndrome in a Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study.

Healthcare (Basel). 2024-1-3

[5]
Effects of empagliflozin on serum uric acid level of patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

Diabetol Metab Syndr. 2023-10-16

[6]
Sodium-Glucose Cotransporter 2 Inhibitors to Decrease the Uric Acid Concentration-A Novel Mechanism of Action.

J Cardiovasc Dev Dis. 2023-6-22

[7]
Pleiotropic Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Cardiovascular Disease and Chronic Kidney Disease.

J Clin Med. 2023-4-12

[8]
rs1014290 Polymorphism is Associated with Prediabetes and Type 2 Diabetes.

Int J Endocrinol. 2022-12-12

[9]
Efficacy and Safety of Empagliflozin in Type 2 Diabetes Mellitus Saudi Patients as Add-On to Antidiabetic Therapy: A Prospective, Open-Label, Observational Study.

J Clin Med. 2022-8-16

[10]
Management of heart failure with preserved ejection fraction: from neurohormonal antagonists to empagliflozin.

Heart Fail Rev. 2023-1

本文引用的文献

[1]
SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review.

Diabetologia. 2018-8-22

[2]
SGLT2 Inhibitors in Type 2 Diabetes Management: Key Evidence and Implications for Clinical Practice.

Diabetes Ther. 2018-10

[3]
Potential mechanisms responsible for cardioprotective effects of sodium-glucose co-transporter 2 inhibitors.

Cardiovasc Diabetol. 2018-7-10

[4]
Cardiovascular effects of sodium glucose cotransporter 2 inhibitors.

Diabetes Metab Syndr Obes. 2018-4-12

[5]
Sodium-Glucose Cotransporter-2 Inhibition in Type 2 Diabetes Mellitus: A Review of Large-Scale Cardiovascular Outcome Studies and Possible Mechanisms of Benefit.

Cardiol Rev. 2018

[6]
A new class of drugs for heart failure: SGLT2 inhibitors reduce sympathetic overactivity.

J Cardiol. 2018-5

[7]
How Does Empagliflozin Reduce Cardiovascular Mortality? Insights From a Mediation Analysis of the EMPA-REG OUTCOME Trial.

Diabetes Care. 2017-12-4

[8]
Effects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure: Proposal of a Novel Mechanism of Action.

JAMA Cardiol. 2017-9-1

[9]
EMPA-REG OUTCOME: The Cardiologist's Point of View.

Am J Cardiol. 2017-7-1

[10]
Cardiovascular Protection in the Treatment of Type 2 Diabetes: A Review of Clinical Trial Results Across Drug Classes.

Am J Cardiol. 2017-7-1

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