Division of Endocrinology and Metabolism, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Division of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
J Diabetes Investig. 2020 Mar;11(2):400-404. doi: 10.1111/jdi.13122. Epub 2019 Aug 14.
Recent studies have shown that sodium-glucose cotransporter 2 inhibitors decrease the risk of heart failure in patients with type 2 diabetes. However, the precise mechanisms of action of these drugs are not well understood. In the present study, we evaluated the effect of treatment with tofogliflozin for 6 months on cardiac and vascular endothelial function in 26 patients with type 2 diabetes and heart diseases. Tofogliflozin treatment significantly decreased left ventricular end-diastolic dimensions and significantly increased flow-mediated vasodilation. Although E/e' did not significantly change after treatment, the decrease observed in the E/e' ratio was significantly correlated with the increase in acetoacetic acid and 3-hydroxybutyrate levels. These results suggest that sodium-glucose cotransporter 2 inhibitor might improve left ventricular dilatation and vascular endothelial function in patients with type 2 diabetes. Furthermore, it is suggested that the elevation of ketone bodies induced by sodium-glucose cotransporter 2 inhibitors might contribute to a protective effect in left ventricular diastolic dysfunction.
最近的研究表明，钠-葡萄糖共转运蛋白 2 抑制剂可降低 2 型糖尿病患者心力衰竭的风险。然而，这些药物的确切作用机制尚不清楚。在本研究中，我们评估了托格列净治疗 6 个月对 26 例合并心脏疾病的 2 型糖尿病患者的心脏和血管内皮功能的影响。托格列净治疗可显著降低左心室舒张末期内径，并显著增加血流介导的血管扩张。尽管治疗后 E/e'没有显著变化，但 E/e'比值的降低与乙酰乙酸和 3-羟基丁酸水平的升高显著相关。这些结果表明，钠-葡萄糖共转运蛋白 2 抑制剂可能改善 2 型糖尿病患者的左心室扩张和血管内皮功能。此外，提示钠-葡萄糖共转运蛋白 2 抑制剂诱导的酮体升高可能对左心室舒张功能障碍具有保护作用。
