钠-葡萄糖协同转运蛋白2抑制剂的心血管效应及机制
Cardiovascular effects and mechanisms of sodium-glucose cotransporter-2 inhibitors.
作者信息
Yang Fan, Meng Ran, Zhu Da-Long
机构信息
Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu 210008, China.
出版信息
Chronic Dis Transl Med. 2020 Aug 15;6(4):239-245. doi: 10.1016/j.cdtm.2020.07.002. eCollection 2020 Dec.
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT2 inhibitors) are a new type of drug for the treatment of diabetes, and they have been proven to have a good hypoglycemic effect. Several lines of clinical evidence have shown that SGLT2 inhibitors can significantly reduce the risks of atherosclerosis, hospitalization for heart failure, cardiovascular death, and all-cause mortality and delay the progression of chronic kidney disease. Because of the protective effects of SGLT2 inhibitors on the heart and kidney, they are being studied for the treatment of heart failure and chronic kidney disease in patients without diabetes. Therefore, it is necessary for cardiologists, patients with diabetes, and nephrologists to fully understand this type of drug. In this review, we summarize the following three aspects of SGLT2 inhibitors: the recent clinical evidence of their cardiovascular benefits, their mechanisms of action, and their safety.
摘要
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2抑制剂）是一种新型的糖尿病治疗药物，已被证明具有良好的降糖效果。多项临床证据表明，SGLT2抑制剂可显著降低动脉粥样硬化、因心力衰竭住院、心血管死亡和全因死亡率的风险，并延缓慢性肾脏病的进展。由于SGLT2抑制剂对心脏和肾脏具有保护作用，目前正在研究其用于治疗非糖尿病患者的心力衰竭和慢性肾脏病。因此，心脏病专家、糖尿病患者和肾脏病专家有必要充分了解这类药物。在本综述中，我们总结了SGLT2抑制剂的以下三个方面：其心血管益处的最新临床证据、作用机制及其安全性。
相似文献
1
Cardiovascular effects and mechanisms of sodium-glucose cotransporter-2 inhibitors.钠-葡萄糖协同转运蛋白2抑制剂的心血管效应及机制
Chronic Dis Transl Med. 2020 Aug 15;6(4):239-245. doi: 10.1016/j.cdtm.2020.07.002. eCollection 2020 Dec.
2
Mechanisms of Protective Effects of SGLT2 Inhibitors in Cardiovascular Disease and Renal Dysfunction.SGLT2 抑制剂在心血管疾病和肾功能障碍中的保护作用机制。
Curr Top Med Chem. 2019;19(20):1818-1849. doi: 10.2174/1568026619666190828161409.
3
Effects of sodium-glucose cotransporter-2 inhibitors on cardiovascular events, death, and major safety outcomes in adults with type 2 diabetes: a systematic review and meta-analysis.钠-葡萄糖共转运蛋白 2 抑制剂对 2 型糖尿病成人患者心血管事件、死亡和主要安全性结局的影响：系统评价和荟萃分析。
Lancet Diabetes Endocrinol. 2016 May;4(5):411-9. doi: 10.1016/S2213-8587(16)00052-8. Epub 2016 Mar 18.
4
Sodium Glucose Cotransporter 2 Inhibitors in the Treatment of Diabetes Mellitus: Cardiovascular and Kidney Effects, Potential Mechanisms, and Clinical Applications.钠-葡萄糖协同转运蛋白2抑制剂在糖尿病治疗中的应用：心血管和肾脏效应、潜在机制及临床应用
Circulation. 2016 Sep 6;134(10):752-72. doi: 10.1161/CIRCULATIONAHA.116.021887. Epub 2016 Jul 28.
5
SGLT2 Inhibition for CKD and Cardiovascular Disease in Type 2 Diabetes: Report of a Scientific Workshop Sponsored by the National Kidney Foundation.SGLT2 抑制剂在 2 型糖尿病患者的慢性肾脏病和心血管疾病中的应用：美国国家肾脏基金会科学研讨会报告。
Am J Kidney Dis. 2021 Jan;77(1):94-109. doi: 10.1053/j.ajkd.2020.08.003. Epub 2020 Oct 26.
6
How Do SGLT2 (Sodium-Glucose Cotransporter 2) Inhibitors and GLP-1 (Glucagon-Like Peptide-1) Receptor Agonists Reduce Cardiovascular Outcomes?: Completed and Ongoing Mechanistic Trials.SGLT2（钠-葡萄糖共转运蛋白 2）抑制剂和 GLP-1（胰高血糖素样肽-1）受体激动剂如何降低心血管结局？：已完成和正在进行的机制试验。
Arterioscler Thromb Vasc Biol. 2020 Mar;40(3):506-522. doi: 10.1161/ATVBAHA.119.311904. Epub 2020 Jan 30.
7
Mechanisms of Cardiorenal Effects of Sodium-Glucose Cotransporter 2 Inhibitors: JACC State-of-the-Art Review.钠-葡萄糖共转运蛋白 2 抑制剂的心脏肾脏作用机制：美国心脏病学会临床心脏病学杂志最新观点述评。
J Am Coll Cardiol. 2020 Feb 4;75(4):422-434. doi: 10.1016/j.jacc.2019.11.031.
8
Sodium-Glucose Cotransporter Type 2 (SGLT-2) Inhibitors and Ketogenesis: the Good and the Bad.钠-葡萄糖共转运蛋白 2（SGLT-2）抑制剂与酮体生成：有利有弊。
Curr Diab Rep. 2020 Nov 23;20(12):74. doi: 10.1007/s11892-020-01359-z.
9
Cardioprotection conferred by sodium-glucose cotransporter 2 inhibitors: a renal proximal tubule perspective.钠-葡萄糖共转运蛋白 2 抑制剂的心脏保护作用：从肾脏近端小管的角度来看。
Am J Physiol Cell Physiol. 2020 Feb 1;318(2):C328-C336. doi: 10.1152/ajpcell.00275.2019. Epub 2019 Nov 13.
10
Cardiovascular Effects of Sodium-Glucose Cotransporter-2 Inhibitors in Adults With Type 2 Diabetes.钠-葡萄糖共转运蛋白 2 抑制剂对 2 型糖尿病成人的心血管影响。
Can J Diabetes. 2020 Feb;44(1):61-67. doi: 10.1016/j.jcjd.2019.09.004. Epub 2019 Sep 24.
引用本文的文献
1
Diabetes Mellitus and Associated Vascular Disease: Pathogenesis, Complications, and Evolving Treatments.糖尿病及相关血管疾病：发病机制、并发症与不断发展的治疗方法
Adv Ther. 2025 Jun;42(6):2659-2678. doi: 10.1007/s12325-025-03185-9. Epub 2025 Apr 19.
2
Sodium-Glucose Cotransporter-2 Inhibitors After Acute Myocardial Infarction.急性心肌梗死后的钠-葡萄糖协同转运蛋白2抑制剂
Biomedicines. 2025 Mar 15;13(3):720. doi: 10.3390/biomedicines13030720.
3
Cardio-renal protective effect and safety of sodium-glucose cotransporter 2 inhibitors for chronic kidney disease patients with eGFR < 60 mL/min/1.73 m2: a systematic review and meta-analysis.钠-葡萄糖共转运蛋白 2 抑制剂对 eGFR<60mL/min/1.73m2 的慢性肾脏病患者的心肾保护作用和安全性：系统评价和荟萃分析。
BMC Nephrol. 2024 Nov 1;25(1):392. doi: 10.1186/s12882-024-03833-2.
4
Systematic Review of Left Ventricular Remodeling in Response to Hypoglycemic Medications: Assessing Changes in End-Systolic and End-Diastolic Diameters.低血糖药物治疗引起的左心室重构的系统评价：评估收缩末期和舒张末期直径的变化
Biomedicines. 2024 Aug 7;12(8):1791. doi: 10.3390/biomedicines12081791.
5
Recent Progress and Perspectives in Sodium-Glucose Co-transporter 1/2 Inhibitors.钠-葡萄糖协同转运蛋白1/2抑制剂的最新进展与展望
Mini Rev Med Chem. 2025;25(5):354-364. doi: 10.2174/0113895575325210240805092741.
6
Brain Regulation of Cardiac Function during Hypoglycemia.低血糖期间心脏功能的脑调节
Metabolites. 2023 Oct 18;13(10):1089. doi: 10.3390/metabo13101089.
7
Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors to Decrease the Risk of Cardiovascular Diseases: A Systematic Review.钠-葡萄糖协同转运蛋白2抑制剂降低心血管疾病风险的疗效与安全性：一项系统评价
Cureus. 2023 Aug 24;15(8):e44054. doi: 10.7759/cureus.44054. eCollection 2023 Aug.
8
Sex differences in cardiovascular outcomes of SGLT-2 inhibitors in heart failure randomized controlled trials: A systematic review and meta-analysis.心力衰竭随机对照试验中SGLT-2抑制剂心血管结局的性别差异：一项系统评价和荟萃分析。
Am Heart J Plus. 2023 Feb;26. doi: 10.1016/j.ahjo.2023.100261. Epub 2023 Jan 30.
9
Unlocking the Full Potential of SGLT2 Inhibitors: Expanding Applications beyond Glycemic Control.解锁 SGLT2 抑制剂的全部潜力：超越血糖控制的应用拓展。
Int J Mol Sci. 2023 Mar 23;24(7):6039. doi: 10.3390/ijms24076039.
10
Empagliflozin Alleviates Left Ventricle Hypertrophy in High-Fat-Fed Mice by Modulating Renin Angiotensin Pathway.恩格列净通过调节肾素-血管紧张素通路缓解高脂喂养小鼠的左心室肥厚。
J Renin Angiotensin Aldosterone Syst. 2022 Jan 18;2022:8861911. doi: 10.1155/2022/8861911. eCollection 2022.
本文引用的文献
1
Empagliflozin ameliorates endothelial dysfunction and suppresses atherogenesis in diabetic apolipoprotein E-deficient mice.恩格列净可改善糖尿病载脂蛋白 E 缺陷小鼠的内皮功能障碍并抑制动脉粥样硬化形成。
Eur J Pharmacol. 2020 May 15;875:173040. doi: 10.1016/j.ejphar.2020.173040. Epub 2020 Feb 27.
2
Canagliflozin Prevents Diabetes-Induced Vascular Dysfunction in ApoE-Deficient Mice.卡格列净可预防载脂蛋白 E 缺陷小鼠的糖尿病血管功能障碍。
J Atheroscler Thromb. 2020 Nov 1;27(11):1141-1151. doi: 10.5551/jat.52100. Epub 2020 Feb 26.
3
Influence of an SGLT2 inhibitor, tofogliflozin, on the resting heart rate in relation to adipose tissue insulin resistance.钠-葡萄糖协同转运蛋白 2（SGLT2）抑制剂托格列净对脂肪组织胰岛素抵抗相关静息心率的影响。
Diabet Med. 2020 Aug;37(8):1316-1325. doi: 10.1111/dme.14279. Epub 2020 Mar 17.
4
Efficacy and safety profile of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease.SGLT2 抑制剂在 2 型糖尿病合并慢性肾脏病患者中的疗效和安全性特征。
Expert Opin Drug Saf. 2020 Mar;19(3):243-256. doi: 10.1080/14740338.2020.1733967. Epub 2020 Mar 2.
5
The risk for urinary tract infections with sodium-glucose cotransporter 2 inhibitors: no longer a cause of concern?钠-葡萄糖协同转运蛋白2抑制剂导致尿路感染的风险：不再令人担忧了吗？
Clin Kidney J. 2019 Dec 18;13(1):24-26. doi: 10.1093/ckj/sfz170. eCollection 2020 Feb.
6
Empagliflozin improved systolic blood pressure, endothelial dysfunction and heart remodeling in the metabolic syndrome ZSF1 rat.恩格列净改善代谢综合征 ZSF1 大鼠的收缩压、内皮功能障碍和心脏重构。
Cardiovasc Diabetol. 2020 Feb 18;19(1):19. doi: 10.1186/s12933-020-00997-7.
7
SGLT2 inhibitor therapy in patients with type-2 diabetes mellitus: is acute kidney injury a concern?钠-葡萄糖协同转运蛋白 2 抑制剂在 2 型糖尿病患者中的治疗作用：急性肾损伤是否值得关注？
J Nephrol. 2020 Oct;33(5):985-994. doi: 10.1007/s40620-020-00712-5. Epub 2020 Feb 18.
8
Treatment strategies for hypertension in patients with type 1 diabetes.1 型糖尿病患者高血压的治疗策略。
Expert Opin Pharmacother. 2020 Jul;21(10):1241-1252. doi: 10.1080/14656566.2020.1729124. Epub 2020 Feb 17.
9
Differentiating the Sodium-Glucose Cotransporter 1 Inhibition Capacity of Canagliflozin vs. Dapagliflozin and Empagliflozin Using Quantitative Systems Pharmacology Modeling.使用定量系统药理学模型区分卡格列净与达格列净和恩格列净对钠-葡萄糖协同转运蛋白1的抑制能力。
CPT Pharmacometrics Syst Pharmacol. 2020 Apr;9(4):222-229. doi: 10.1002/psp4.12498. Epub 2020 Mar 6.
10
SGLT2 inhibitors - a potential treatment for Alport syndrome.SGLT2 抑制剂——治疗 Alport 综合征的一种潜在疗法。
Clin Sci (Lond). 2020 Feb 28;134(4):379-388. doi: 10.1042/CS20191276.
Zotero 插件