Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
Research Unit of Cardiovascular Sciences, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
Int J Mol Sci. 2023 Jun 15;24(12):10164. doi: 10.3390/ijms241210164.
Type-2 diabetes mellitus (DM) represents one of the most important risk factors for cardiovascular diseases (CVD). Hyperglycemia and glycemic variability are not the only determinant of the increased cardiovascular (CV) risk in diabetic patients, as a frequent metabolic disorder associated with DM is dyslipidemia, characterized by hypertriglyceridemia, decreased high-density lipoprotein (HDL) cholesterol levels and a shift towards small dense low-density lipoprotein (LDL) cholesterol. This pathological alteration, also called diabetic dyslipidemia, represents a relevant factor which could promotes atherosclerosis and subsequently an increased CV morbidity and mortality. Recently, the introduction of novel antidiabetic agents, such as sodium glucose transporter-2 inhibitors (SGLT2i), dipeptidyl peptidase-4 inhibitors (DPP4i) and glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs), has been associated with a significant improvement in CV outcomes. Beyond their known action on glycemia, their positive effects on the CV system also seems to be related to an ameliorated lipidic profile. In this context, this narrative review summarizes the current knowledge regarding these novel anti-diabetic drugs and their effects on diabetic dyslipidemia, which could explain the provided global benefit to the cardiovascular system.
2 型糖尿病（DM）是心血管疾病（CVD）最重要的危险因素之一。高血糖和血糖变异性并不是糖尿病患者心血管（CV）风险增加的唯一决定因素，因为与 DM 相关的一种常见代谢紊乱是血脂异常，其特征是甘油三酯升高、高密度脂蛋白（HDL）胆固醇水平降低以及小而密的低密度脂蛋白（LDL）胆固醇转移。这种病理性改变，也称为糖尿病血脂异常，是一种重要的促进动脉粥样硬化的因素，进而导致心血管发病率和死亡率增加。最近，新型抗糖尿病药物的引入，如钠-葡萄糖协同转运蛋白 2 抑制剂（SGLT2i）、二肽基肽酶-4 抑制剂（DPP4i）和胰高血糖素样肽-1（GLP-1）受体激动剂（GLP-1 RAs），与 CV 结局的显著改善相关。除了已知的对血糖的作用外，它们对心血管系统的积极影响似乎也与脂质谱的改善有关。在这种情况下，本综述总结了这些新型抗糖尿病药物及其对糖尿病血脂异常的作用的最新知识，这可以解释它们对心血管系统的整体益处。
