Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Department of Physiology, University of Toronto, Toronto, Ontario, Canada; Cardiovascular Sciences Collaborative Specialization, University of Toronto, Toronto, Canada.
Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Metabolism. 2024 Apr;153:155785. doi: 10.1016/j.metabol.2024.155785. Epub 2024 Jan 11.
The coexistence of cardiovascular disease (CVD) and diabetic kidney disease (DKD) is common in people with type 1 diabetes (T1D) and is strongly associated with an increased risk of morbidity and mortality. Hence, it is imperative to explore robust tools that can accurately reflect the development and progression of cardiorenal complications. Several cardiovascular and kidney biomarkers have been identified to detect at-risk individuals with T1D. The primary aim of this review is to highlight biomarkers of injury, inflammation, or renal hemodynamic changes that may influence T1D susceptibility to CVD and DKD. We will also examine the impact of approved pharmacotherapies for type 2 diabetes, including renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on candidate biomarkers for cardiorenal complications in people with T1D and discuss how these changes may potentially mediate kidney and cardiovascular protection. Identifying predictive and prognostic biomarkers for DKD and CVD may highlight potential drug targets to attenuate cardiorenal disease progression, implement novel risk stratification measures in clinical trials, and improve the assessment, diagnosis, and treatment of at-risk individuals with T1D.
心血管疾病 (CVD) 和糖尿病肾脏疾病 (DKD) 在 1 型糖尿病 (T1D) 患者中并存较为常见，并且与发病率和死亡率的增加密切相关。因此，探索能够准确反映心脏和肾脏并发症发生和进展的可靠工具至关重要。已经确定了几种心血管和肾脏生物标志物，用于检测存在风险的 T1D 个体。本综述的主要目的是强调可能影响 T1D 易患 CVD 和 DKD 的损伤、炎症或肾脏血液动力学变化的生物标志物。我们还将研究已批准的用于 2 型糖尿病的药物治疗（包括肾素-血管紧张素-醛固酮系统 (RAAS) 抑制剂、钠-葡萄糖共转运蛋白 2 (SGLT2) 抑制剂和胰高血糖素样肽-1 受体激动剂 (GLP-1RAs)）对 T1D 患者心脏和肾脏并发症候选生物标志物的影响，并讨论这些变化如何可能潜在介导肾脏和心血管保护。确定 DKD 和 CVD 的预测和预后生物标志物可能突出潜在的药物靶点，以减轻心脏和肾脏疾病的进展，在临床试验中实施新的风险分层措施，并改善高危 T1D 个体的评估、诊断和治疗。
