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通过纵向临床数据库分析探讨SGLT-2抑制剂对2型糖尿病患者心力衰竭的保护作用

Protective Influence of SGLT-2 Inhibitors Against Heart Failure in Type 2 Diabetes Mellitus Through Longitudinal Clinical Database Analysis.

作者信息

Nagy Attila Csaba, Tóth Ágnes, Bak Natália, Ulambayar Battamir, Ghanem Amr Sayed, Sztanek Ferenc

机构信息

Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary.

Department of Integrative Health Sciences, Faculty of Health Sciences, University of Debrecen, 4028 Debrecen, Hungary.

出版信息

J Clin Med. 2024 Nov 24;13(23):7093. doi: 10.3390/jcm13237093.

Abstract

: Sodium-glucose co-transporter 2 (SGLT-2) inhibitors, initially designed for type 2 diabetes, promote glucose excretion and lower blood glucose. Newer analogs like empagliflozin and dapagliflozin improve cardiovascular outcomes through mechanisms other than glycemic control, including blood pressure reduction and anti-inflammatory effects. Given the high cardiovascular risk present in diabetes, our study aims to emphasize the cardioprotective benefits of SGLT-2 inhibitors as a preventive therapy for heart failure (HF) in high-risk T2DM patients. : Using data from 2542 patients identified by the ICD-10 E11 code from 2016 to 2020, this longitudinal study excluded those with E10 codes or those undergoing insulin treatment to focus on non-insulin-dependent T2DM. a multiple logistic regression model assessed HF incidence while adjusting for demographics and HbA1c. : SGLT-2 inhibitor use significantly lowered the odds of heart failure events (OR = 0.55, 95% CI: 0.31-0.99, = 0.046), with a significant difference by gender (OR = 0.45, 95% CI: 0.28-0.71, = 0.001) and eGFR (OR = 0.98, 95% CI: 0.97-0.99, = 0.004). : The real-world data highlight SGLT-2 inhibitors as promising for HF prevention and broader cardiometabolic health in T2DM, with potential value in managing complex comorbid profiles.

摘要

钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂最初是为2型糖尿病设计的,可促进葡萄糖排泄并降低血糖。恩格列净和达格列净等新型类似物通过血糖控制以外的机制改善心血管结局,包括降低血压和抗炎作用。鉴于糖尿病患者存在较高的心血管风险,我们的研究旨在强调SGLT-2抑制剂作为高危2型糖尿病患者心力衰竭(HF)预防性治疗的心脏保护益处。:利用2016年至2020年通过ICD-10 E11编码确定的2542名患者的数据,这项纵向研究排除了患有E10编码的患者或接受胰岛素治疗的患者,以专注于非胰岛素依赖型2型糖尿病。一个多元逻辑回归模型在调整人口统计学和糖化血红蛋白(HbA1c)的同时评估了心力衰竭的发生率。:使用SGLT-2抑制剂显著降低了心力衰竭事件的发生几率(比值比[OR]=0.55,95%置信区间[CI]:0.31-0.99,P=0.046),按性别(OR=0.45,95%CI:0.28-0.71,P=0.001)和估算肾小球滤过率(eGFR)(OR=0.98,95%CI:0.97-0.99,P=0.004)有显著差异。:真实世界数据突出了SGLT-2抑制剂在2型糖尿病患者预防心力衰竭和更广泛的心脏代谢健康方面具有前景,在管理复杂的合并症方面具有潜在价值。

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