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SGLT2(钠-葡萄糖转运蛋白 2 型)抑制剂诱导人内脏脂肪组织动脉舒张的机制。

Mechanisms of SGLT2 (Sodium-Glucose Transporter Type 2) Inhibition-Induced Relaxation in Arteries From Human Visceral Adipose Tissue.

机构信息

From the Department of Systems Medicine, Università Tor Vergata, Roma, Italy (A.D.S., M.T., N.D.D.).

Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Roma, Italy (G.V., C.C.).

出版信息

Hypertension. 2021 Feb;77(2):729-738. doi: 10.1161/HYPERTENSIONAHA.120.16466. Epub 2020 Dec 28.

Abstract

As novel drug treatments for diabetes have shown favorable cardiovascular effects, interest has mounted with regard to their possible vascular actions, particularly in relation to visceral adipose tissue perfusion and remodeling in obesity. The present study tested the vasorelaxing effect of the SGLT2 (sodium-glucose transporter type 2) inhibitor canagliflozin in arteries from visceral adipose tissue of either nonobese or obese humans and investigated the underlying mechanisms. Also, the vasorelaxing effect of canagliflozin and the GLP-1 (glucagon-like peptide 1) agonist liraglutide were compared in arteries from obese patients. To these purposes, small arteries (116-734 μm) isolated from visceral adipose tissue were studied ex vivo in a wire myograph. Canagliflozin elicited a higher concentration-dependent vasorelaxation in arterioles from obese than nonobese individuals (=0.02). The vasorelaxing response to canagliflozin was not modified (=0.93) by inhibition of nitric oxide synthase (L-NAME) or prostacyclin (indomethacin), or by HO scavenging (catalase); also, canagliflozin-induced relaxation was similar (=0.23) in endothelium-intact or -denuded arteries precontracted with high potassium concentration, thereby excluding an involvement of endothelium-derived hyperpolarizing factors. The vasorelaxing response to canagliflozin was similar to that elicited by the Na/H exchanger 1 inhibitor BIX (=0.67), but greater than that to the Na/Ca exchanger inhibitor SEA 0400 (=0.001), hinting a role of Na/H exchanger inhibition in canagliflozin-induced relaxation. In arterioles from obese patients, the vasorelaxing response to canagliflozin was greater than that to liraglutide (=0.004). These findings demonstrate that canagliflozin induces endothelium-independent vasorelaxation in arterioles from human visceral adipose tissue, thereby suggesting that SGLT2 inhibition might favorably impact the processes linking visceral adipose burden to vascular disease in obesity.

摘要

随着新型糖尿病药物治疗显示出有利的心血管作用,人们对其可能的血管作用产生了浓厚的兴趣,特别是与肥胖相关的内脏脂肪组织灌注和重塑。本研究测试了 SGLT2(钠-葡萄糖转运蛋白 2)抑制剂卡格列净对非肥胖或肥胖人群内脏脂肪组织动脉的血管舒张作用,并探讨了其潜在机制。此外,还比较了卡格列净和 GLP-1(胰高血糖素样肽 1)激动剂利拉鲁肽在肥胖患者动脉中的血管舒张作用。为此,在体外血管环中研究了从小鼠内脏脂肪组织分离的小动脉(116-734μm)。卡格列净在肥胖个体的小动脉中引起了更高浓度依赖性的血管舒张作用(=0.02)。NO 合酶(L-NAME)或前列环素(吲哚美辛)的抑制、HO 清除(过氧化氢酶)或内皮完整或去内皮的小动脉对高钾预收缩的反应,均不改变卡格列净的血管舒张反应(=0.93),从而排除了内皮衍生的超极化因子的参与。卡格列净诱导的舒张作用在高钾预收缩的内皮完整或去内皮的小动脉中相似(=0.23),从而排除了内皮衍生的超极化因子的参与。卡格列净的血管舒张反应与 Na/H 交换器 1 抑制剂 BIX(=0.67)相似,但大于 Na/Ca 交换器抑制剂 SEA 0400(=0.001),提示 Na/H 交换器抑制在卡格列净诱导的舒张反应中起作用。在肥胖患者的小动脉中,卡格列净的血管舒张反应大于利拉鲁肽(=0.004)。这些发现表明,卡格列净在人内脏脂肪组织的小动脉中引起内皮非依赖性血管舒张,提示 SGLT2 抑制可能有利于肥胖患者内脏脂肪负担与血管疾病之间的过程。

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