Morciano Cassandra, Gugliandolo Shawn, Capece Umberto, Di Giuseppe Gianfranco, Mezza Teresa, Ciccarelli Gea, Soldovieri Laura, Brunetti Michela, Avolio Adriana, Splendore Amelia, Pontecorvi Alfredo, Giaccari Andrea, Cinti Francesca
Centro Malattie Endocrine e Metaboliche, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
Cardiovasc Diabetol. 2024 Dec 19;23(1):449. doi: 10.1186/s12933-024-02539-x.
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have emerged as important agents for the treatment of type 2 diabetes mellitus (T2DM). SGLT2 inhibitors have been associated with improved cardiovascular outcomes, not only through their immediate hemodynamic effects-such as glycosuria and (at least temporary) increased natriuresis-but also due to their multifaceted impact on metabolism. Recently, studies have also focused on the effects of SGLT2 inhibitors on adipose tissue. Aside from the well-documented effects on human adiposity, SGLT2i have shown, both in vitro and in murine models, the ability to reduce fat mass, upregulate genes related to browning of white adipose tissue, influence adipocyte size and fatty acid oxidation, and improve oxidative stress and overall metabolic health. In humans, even though data are still limited, recent evidence seems to confirm that the SGLT2i effects observed in cardiovascular outcome trials could be partially explained by their impact on adipose tissue. This review aims to clarify the impact of SGLT2i on adipose tissue, highlighting their role in metabolic health and their potential to transform treatment strategies for T2DM beyond glucose metabolism.
钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）已成为治疗2型糖尿病（T2DM）的重要药物。SGLT2抑制剂不仅通过其直接的血流动力学效应（如糖尿和（至少是暂时的）尿钠排泄增加），还因其对代谢的多方面影响，与改善心血管结局相关。最近，研究也聚焦于SGLT2抑制剂对脂肪组织的作用。除了对人体肥胖的明确作用外，SGLT2i在体外和小鼠模型中均显示出减少脂肪量、上调与白色脂肪组织褐变相关基因、影响脂肪细胞大小和脂肪酸氧化以及改善氧化应激和整体代谢健康的能力。在人类中，尽管数据仍然有限，但最近的证据似乎证实，在心血管结局试验中观察到的SGLT2i效应可能部分归因于其对脂肪组织的影响。本综述旨在阐明SGLT2i对脂肪组织的影响，强调其在代谢健康中的作用以及超越葡萄糖代谢改变T2DM治疗策略的潜力。
