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钠-葡萄糖协同转运蛋白 2 抑制剂作为心脏-肾脏保护剂。

SGLT-2 inhibitors as cardio-renal protective agents.

机构信息

Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.

Department of Emergency and Organ Transplantation, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.

出版信息

Metabolism. 2022 Feb;127:154937. doi: 10.1016/j.metabol.2021.154937. Epub 2021 Nov 19.


DOI:10.1016/j.metabol.2021.154937
PMID:34808144
Abstract

Despite remarkable advances in diabetes care, patients with type 2 diabetes are still burdened by higher morbidity and mortality than non-diabetic individuals. Atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease represent the most relevant causes of morbidity and mortality and sustain each other in a vicious circle. Cardiovascular diseases are the main cause of death in patients with chronic kidney disease, and, in turn, chronic kidney disease is a significant contributor to the risk of major cardiovascular events and hospitalization for heart failure. Cardiovascular outcome trials with SGLT-2 inhibitors in type 2 diabetes yielded unprecedented results on prevention of worsening heart failure and renal disease progression and mortality, further confirmed by randomized controlled trials in patients with baseline heart failure and chronic kidney disease, with or without diabetes, and observations from the real-world setting. However, the evidence regarding SGLT-2 inhibitors benefit on atherosclerotic cardiovascular events is conflicting. Hence, SGLT-2 inhibitors represent a remarkably valuable weapon in diabetes management, to be used in the context of a multi-targeted treatment strategy to address the many issues of this multifaceted disease.

摘要

尽管糖尿病治疗取得了显著进展,但 2 型糖尿病患者的发病率和死亡率仍高于非糖尿病患者。动脉粥样硬化性心血管疾病、心力衰竭和慢性肾脏病是发病率和死亡率的主要原因,并在恶性循环中相互维持。心血管疾病是慢性肾脏病患者死亡的主要原因,而慢性肾脏病则是发生主要心血管事件和心力衰竭住院的重要危险因素。在 2 型糖尿病患者中进行的 SGLT-2 抑制剂心血管结局试验在预防心力衰竭恶化和肾脏疾病进展及死亡率方面取得了前所未有的结果,在基线时患有心力衰竭和慢性肾脏病的患者中进行的随机对照试验以及真实世界的观察结果进一步证实了这一点,无论是否合并糖尿病。然而,关于 SGLT-2 抑制剂对动脉粥样硬化性心血管事件的益处的证据存在争议。因此,SGLT-2 抑制剂是糖尿病管理中非常有价值的武器,可在多目标治疗策略的背景下使用,以解决这种多方面疾病的许多问题。

相似文献

[1]
SGLT-2 inhibitors as cardio-renal protective agents.

Metabolism. 2022-2

[2]
The effect of SGLT-2 inhibitors on blood pressure: a pleiotropic action favoring cardio- and nephroprotection.

Future Med Chem. 2019-6-4

[3]
Pleiotropic effects of antidiabetic agents on renal and cardiovascular outcomes: a meta-analysis of randomized controlled trials.

Int Urol Nephrol. 2020-9

[4]
Sodium glucose cotransporter (SGLT)-2 inhibitors: Do we need them for glucose-lowering, for cardiorenal protection or both?

Diabetes Obes Metab. 2019-4

[5]
The Effects of SGLT2 Inhibitors on Cardiovascular and Renal Outcomes in Diabetic Patients: A Systematic Review and Meta-Analysis.

Cardiorenal Med. 2020

[6]
Renoprotective effects of sodium-glucose cotransporter-2 inhibitors.

Kidney Int. 2018-5-5

[7]
Effects of sodium-glucose cotransporter type 2 inhibitors on cardiovascular, renal, and safety outcomes in patients with cardiovascular disease: a meta-analysis of randomized controlled trials.

Cardiovasc Diabetol. 2021-4-22

[8]
Cardiovascular outcomes associated with SGLT-2 inhibitors versus other glucose-lowering drugs in patients with type 2 diabetes: A real-world systematic review and meta-analysis.

PLoS One. 2021-2-19

[9]
Cardiovascular and renal outcomes with SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with type 2 diabetes mellitus and chronic kidney disease: a systematic review and network meta-analysis.

Cardiovasc Diabetol. 2021-1-7

[10]
Renal effects of sodium-glucose cotransporter-2 inhibitors in patients with type 2 diabetes and renal impairment.

Postgrad Med. 2019-6-5

引用本文的文献

[1]
Evaluating the Safety and Efficacy of SGLT-2 Inhibitors on Reducing Cardiovascular and Renal Mortality, Morbidity and Inflammatory Outcomes in Various Patient Populations: A Systematic Review and Meta-Analysis of 92 920 Patients.

Clin Med Insights Cardiol. 2025-6-30

[2]
The use of SGLT2 inhibitors in people with diabetes-related foot disease: A Delphi-based consensus study.

Diabetes Obes Metab. 2025-8

[3]
Exploration of metformin-based drug combination for mitigating diabetes-associated atherosclerotic diseases.

World J Diabetes. 2025-4-15

[4]
Heart Failure in Older Patients: An Update.

J Clin Med. 2025-3-14

[5]
Asymptomatic Hyperuricemia and the Kidney: Lessons from the URRAH Study.

Metabolites. 2025-1-2

[6]
Cardiovascular Therapy Benefits of Novel Antidiabetic Drugs in Patients With Type 2 Diabetes Mellitus Complicated With Cardiovascular Disease: A Network Meta-Analysis.

J Diabetes. 2025-1

[7]
Comparative efficacy of GLP-1 RAs/SGLT-2 inhibitors in reducing cardiovascular events in type 2 diabetes according to baseline use of metformin: a systematic review and meta-analysis of randomized controlled trials.

Eur J Med Res. 2025-1-7

[8]
Sigma-1 Receptor as a Novel Therapeutic Target in Diabetic Kidney Disease.

Int J Mol Sci. 2024-12-12

[9]
New Insights into the Role of SGLT-2 Inhibitors in the Prevention of Dementia.

Neurol Int. 2024-12-5

[10]
Protective Influence of SGLT-2 Inhibitors Against Heart Failure in Type 2 Diabetes Mellitus Through Longitudinal Clinical Database Analysis.

J Clin Med. 2024-11-24

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