Montage Medical Group, Monterey, California, USA.
Department of Endocrinology, VAMC and George Washington University School of Medicine, Washington, District of Columbia, USA.
Metab Syndr Relat Disord. 2022 Aug;20(6):321-328. doi: 10.1089/met.2022.0004. Epub 2022 Apr 22.
The introduction of sodium glucose transporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in type 2 diabetes mellitus treatment has shown an unexpectedly significant improvement in heart disease outcome trials. Although they have very different modes of action, a portion of the salutary cardiovascular disease improvement may be related to their impact on diabetic dyslipidemia. As discussed in this focused review, the sodium glucose transporter-2 inhibitors as a class show a mild increase in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol levels, while triglycerides (TG) decrease inconsistently. In particular, the rise in LDL appears to be related to the less atherogenic, large buoyant LDL particles. The glucagon-like peptide-1 receptor agonists show more of an impact on weight loss and improvement in the underlying low HDL and high TG dyslipidemia. The effect of sodium glucose transporter-2 inhibitors and glucagon-like peptide 1 receptor agonists when used in combination remains largely unknown. Also unexplored is difference in effect of these medications among various ethnicities and metabolic syndrome.
钠-葡萄糖协同转运蛋白 2 抑制剂和胰高血糖素样肽-1 受体激动剂在 2 型糖尿病治疗中的应用，在心脏病结局试验中显示出出乎意料的显著改善。尽管它们的作用机制非常不同，但一部分有益的心血管疾病改善可能与它们对糖尿病血脂异常的影响有关。正如本篇重点综述所讨论的，该类钠-葡萄糖协同转运蛋白 2 抑制剂整体上显示出 LDL 胆固醇和 HDL 胆固醇水平的轻度升高，而甘油三酯（TG）则不一致地降低。特别是 LDL 的升高似乎与致动脉粥样硬化性较小、较大浮力 LDL 颗粒有关。胰高血糖素样肽-1 受体激动剂对体重减轻和改善潜在的低 HDL 和高 TG 血脂异常的影响更大。当联合使用钠-葡萄糖协同转运蛋白 2 抑制剂和胰高血糖素样肽 1 受体激动剂时，其效果在很大程度上仍然未知。此外，这些药物在不同种族和代谢综合征中的作用差异也尚未得到探索。
