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2型糖尿病与心力衰竭中的钠-葡萄糖协同转运蛋白2抑制剂——简要综述

SGLT2 Inhibitors in Type 2 Diabetes Mellitus and Heart Failure-A Concise Review.

作者信息

Keller Daria M, Ahmed Natasha, Tariq Hamza, Walgamage Malsha, Walgamage Thilini, Mohammed Azad, Chou Jadzia Tin-Tsen, Kałużna-Oleksy Marta, Lesiak Maciej, Straburzyńska-Migaj Ewa

机构信息

Ist Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznan, Poland.

Cardiology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston PR2 9HT, UK.

出版信息

J Clin Med. 2022 Mar 8;11(6):1470. doi: 10.3390/jcm11061470.


DOI:10.3390/jcm11061470
PMID:35329796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8952302/
Abstract

The incidence of both diabetes mellitus type 2 and heart failure is rapidly growing, and the diseases often coexist. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) are a new antidiabetic drug class that mediates epithelial glucose transport at the renal proximal tubules, inhibiting glucose absorption-resulting in glycosuria-and therefore improving glycemic control. Recent trials have proven that SGLT2i also improve cardiovascular and renal outcomes, including reduced cardiovascular mortality and fewer hospitalizations for heart failure. Reduced preload and afterload, improved vascular function, and changes in tissue sodium and calcium handling may also play a role. The expected paradigm shift in treatment strategies was reflected in the most recent 2021 guidelines published by the European Society of Cardiology, recommending dapagliflozin and empagliflozin as first-line treatment for heart failure patients with reduced ejection fraction. Moreover, the recent results of the EMPEROR-Preserved trial regarding empagliflozin give us hope that there is finally an effective treatment for patients with heart failure with preserved ejection fraction. This review aims to assess the efficacy and safety of these new anti-glycemic oral agents in the management of diabetic and heart failure patients.

摘要

2型糖尿病和心力衰竭的发病率都在迅速上升,且这两种疾病常常并存。钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)是一类新型抗糖尿病药物,可介导肾近端小管的上皮葡萄糖转运,抑制葡萄糖吸收,导致糖尿,从而改善血糖控制。近期试验已证实,SGLT2i还可改善心血管和肾脏结局,包括降低心血管死亡率以及减少因心力衰竭住院的次数。前负荷和后负荷降低、血管功能改善以及组织钠和钙处理的变化也可能起作用。治疗策略的预期范式转变反映在欧洲心脏病学会发布的最新2021年指南中,该指南推荐达格列净和恩格列净作为射血分数降低的心力衰竭患者的一线治疗药物。此外,恩格列净的EMPEROR-Preserved试验的最新结果让我们看到希望,即对于射血分数保留的心力衰竭患者终于有了一种有效的治疗方法。本综述旨在评估这些新型口服降糖药物在糖尿病和心力衰竭患者管理中的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/6b8eacbbb43e/jcm-11-01470-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/8879303195bf/jcm-11-01470-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/f230274599d1/jcm-11-01470-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/14cfe9577ac0/jcm-11-01470-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/6b8eacbbb43e/jcm-11-01470-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/8879303195bf/jcm-11-01470-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/f230274599d1/jcm-11-01470-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/14cfe9577ac0/jcm-11-01470-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06e/8952302/6b8eacbbb43e/jcm-11-01470-g004.jpg

相似文献

[1]
SGLT2 Inhibitors in Type 2 Diabetes Mellitus and Heart Failure-A Concise Review.

J Clin Med. 2022-3-8

[2]
Emerging concepts in heart failure management and treatment: focus on SGLT2 inhibitors in heart failure with preserved ejection fraction.

Drugs Context. 2023-1-4

[3]
Evaluation of the effect of sodium-glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality of patients with chronic heart failure and a reduced ejection fraction: rationale for and design of the EMPEROR-Reduced trial.

Eur J Heart Fail. 2019-7-16

[4]
SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials.

Lancet. 2020-8-30

[5]
Sodium-glucose co-transporter 2 inhibitors in heart failure: beyond glycaemic control. A position paper of the Heart Failure Association of the European Society of Cardiology.

Eur J Heart Fail. 2020-9

[6]
Update on the Cardiovascular Benefits of Sodium-Glucose Co-Transporter-2 Inhibitors: Mechanism of Action, Available Agents and Comprehensive Review of Literature.

Cardiol Res. 2021-8

[7]
Sodium-glucose co-transporter-2 inhibitors eligibility in patients with heart failure with reduced ejection fraction.

Int J Cardiol. 2021-10-15

[8]
Evaluation of the effects of sodium-glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality in patients with chronic heart failure and a preserved ejection fraction: rationale for and design of the EMPEROR-Preserved Trial.

Eur J Heart Fail. 2019-9-16

[9]
Clinical potential relevance of metabolic properties of SGLT2 inhibitors in patients with heart failure.

Expert Opin Drug Metab Toxicol. 2018-12-4

[10]
Impact of SGLT2 inhibitors on cardiovascular outcomes in patients with heart failure with reduced ejection fraction.

Pharmacotherapy. 2021-6

引用本文的文献

[1]
SGLT2 Inhibitors: From Molecular Mechanisms to Clinical Outcomes in Cardiology and Diabetology.

Molecules. 2025-7-25

[2]
Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors in Heart Failure With Preserved Ejection Fraction: A Systematic Review.

Cureus. 2025-6-19

[3]
Efficacy and Safety of SGLT2 Inhibitors in Pediatric Patients and Young Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pediatr Diabetes. 2024-10-22

[4]
The Impact of Sodium-Glucose Co-Transporter-2 Inhibition on Insulin Resistance and Inflammation in Patients with Type 2 Diabetes: A Retrospective Study.

Medicina (Kaunas). 2025-1-24

[5]
Subcellular mass spectrometric detection unveils hyperglycemic memory in the diabetic heart.

J Diabetes. 2024-11

[6]
Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Cardiovascular and Renal Outcomes in Heart Failure Patients With Type 2 Diabetes: A Literature Review.

J Clin Med Res. 2024-9

[7]
"Emerging clinical approaches in diabetic cardiomyopathy: insights from clinical trials and future directions".

Acta Diabetol. 2025-1

[8]
Examining the Impact of Ertugliflozin on Cardiovascular Outcomes in Patients with Diabetes and Metabolic Syndrome: A Systematic Review of Clinical Trials.

Pharmaceuticals (Basel). 2024-7-11

[9]
Diabetes and Heart Failure: A Literature Review, Reflection and Outlook.

Biomedicines. 2024-7-15

[10]
The Renoprotective Mechanisms of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i)-A Narrative Review.

Int J Mol Sci. 2024-6-27

本文引用的文献

[1]
Cardiovascular Benefits from Gliflozins: Effects on Endothelial Function.

Biomedicines. 2021-9-29

[2]
Sodium-glucose cotransporter 2 inhibitors and heart failure: the best timing for the right patient.

Heart Fail Rev. 2023-5

[3]
Empagliflozin in Heart Failure with a Preserved Ejection Fraction.

N Engl J Med. 2021-10-14

[4]
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.

Eur Heart J. 2021-9-21

[5]
The Diabetic Cardiomyopathy: The Contributing Pathophysiological Mechanisms.

Front Med (Lausanne). 2021-6-30

[6]
Impact of SGLT2 Inhibitors on Heart Failure: From Pathophysiology to Clinical Effects.

Int J Mol Sci. 2021-5-30

[7]
Endothelial function and dysfunction: Impact of sodium-glucose cotransporter 2 inhibitors.

Pharmacol Ther. 2021-8

[8]
How Should We Sequence the Treatments for Heart Failure and a Reduced Ejection Fraction?: A Redefinition of Evidence-Based Medicine.

Circulation. 2021-3-2

[9]
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure.

N Engl J Med. 2021-1-14

[10]
Molecular Mechanisms of SGLT2 Inhibitor on Cardiorenal Protection.

Int J Mol Sci. 2020-10-22

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