Garla Vishnu, Subauste Angela, Butler Javed, Lien Lillian F
Department of Medicine, University of Mississippi Medical Center, Jackson, USA; Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Mississippi Medical Center, Jackson, USA; Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, USA.
Department of Medicine, University of Mississippi Medical Center, Jackson, USA; Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Mississippi Medical Center, Jackson, USA.
J Diabetes Complications. 2021 Mar;35(3):107811. doi: 10.1016/j.jdiacomp.2020.107811. Epub 2020 Nov 26.
The worldwide prevalences of diabetes mellitus (DM) and of heart failure (HF) have collectively been on the rise. HF accounts for a large portion of the cardiovascular mortality and morbidity associated with DM. DM increases the risk of developing heart failure by promoting atherosclerosis and exerting direct deleterious effects on the myocardium. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are agents approved for the treatment of DM; they exert their anti-hyperglycemic effects by blocking renal reabsorption of glucose and inducing glycosuria. SGLT-2 inhibitors have consistently decreased the hospitalization rate of HF and cardiovascular mortality in several clinical trials. SGLT-2 inhibitors also possess anti-inflammatory, anti-fibrotic, and antihypertensive in addition to beneficial effects on the myocardial metabolism, which may account for their heart failure benefits. However, further research still needs to be done to evaluate the use of SGLT-2 inhibitors in non-diabetic patients and their efficacy in preventing or treating different heart failure phenotypes.
全球糖尿病（DM）和心力衰竭（HF）的患病率总体呈上升趋势。HF在与DM相关的心血管死亡率和发病率中占很大比例。DM通过促进动脉粥样硬化和对心肌产生直接有害作用，增加了发生心力衰竭的风险。钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂是被批准用于治疗DM的药物；它们通过阻断肾脏对葡萄糖的重吸收和诱导糖尿来发挥降糖作用。在多项临床试验中，SGLT-2抑制剂持续降低了HF的住院率和心血管死亡率。SGLT-2抑制剂除了对心肌代谢有有益作用外，还具有抗炎、抗纤维化和降压作用，这可能是它们对心力衰竭有益的原因。然而，仍需进一步研究以评估SGLT-2抑制剂在非糖尿病患者中的应用及其预防或治疗不同心力衰竭表型的疗效。
