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抗糖尿病药物胰高血糖素样肽-1受体激动剂(GLP-1RA)和钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i)对呼吸系统功能的潜在影响。

The possible effect of anti-diabetic agents GLP-1RA and SGLT-2i on the respiratory system function.

作者信息

Kantreva Kanella, Katsaounou Paraskevi, Saltiki Katerina, Trakada Georgia, Ntali Georgia, Stratigou Theodora, Tzanela Marinella, Psaltopoulou Theodora, Paschou Stavroula A

机构信息

Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Department of Endocrinology, Diabetes Centre, Endo ERN member, Evangelismos General Hospital, Athens, Greece.

出版信息

Endocrine. 2025 Feb;87(2):378-388. doi: 10.1007/s12020-024-04033-6. Epub 2024 Sep 17.

DOI:10.1007/s12020-024-04033-6
PMID:39289244
Abstract

Type 2 Diabetes (T2D) is a chronic disease with increasing incidence and prevalence and serious chronic complications, especially from cardiovascular system. However, other organs can be affected too. Several studies have associated T2D, especially when poorly controlled, with multiple pulmonary diseases. T2D is a common comorbidity among patients with asthma, Chronic Obstructive Pulmonary Disease (COPD), and Obstructive Sleep Apnea Syndrome (OSAS), and it is related to higher respiratory infection incidence, prevalence and severity. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and Sodium-glucose co-transporter-2 inhibitors (SGLT-2i) are novel antihyperglycaemic agents with established cardiovascular benefits. There are also limited studies indicating their potential benefit in respiratory function. The aim of this article is to review data on the impact of GLP-1RA and SGLT-2i on respiratory function and describe the possible clinical benefits. Key findings indicate that GLP-1RA significantly improve lung function in patients with COPD, evidenced by improvements in spirometry measurements. Additionally, both GLP-1RA and SGLT-2i are associated with a decreased risk of severe and moderate exacerbations in COPD patients and have shown potential in reducing the incidence of respiratory disorders, including asthma and pneumonia. The mechanisms underlying these benefits are not yet fully understood and include multiple effects, such as anti-inflammatory action and oxidative stress reduction.

摘要

2型糖尿病(T2D)是一种发病率和患病率不断上升且伴有严重慢性并发症的慢性疾病,尤其是心血管系统并发症。然而,其他器官也可能受到影响。多项研究表明,T2D,尤其是控制不佳时,与多种肺部疾病有关。T2D是哮喘、慢性阻塞性肺疾病(COPD)和阻塞性睡眠呼吸暂停综合征(OSAS)患者中的常见合并症,并且与更高的呼吸道感染发病率、患病率和严重程度相关。胰高血糖素样肽-1受体激动剂(GLP-1RA)和钠-葡萄糖协同转运蛋白-2抑制剂(SGLT-2i)是具有明确心血管益处的新型降糖药物。也有有限的研究表明它们在呼吸功能方面具有潜在益处。本文的目的是综述关于GLP-1RA和SGLT-2i对呼吸功能影响的数据,并描述可能的临床益处。主要研究结果表明,GLP-1RA可显著改善COPD患者的肺功能,这在肺量计测量结果的改善中得到了证实。此外,GLP-1RA和SGLT-2i均与COPD患者中重度加重风险的降低相关,并已显示出在降低包括哮喘和肺炎在内的呼吸系统疾病发病率方面的潜力。这些益处背后的机制尚未完全了解,包括多种作用,如抗炎作用和氧化应激的降低。

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