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2型糖尿病中钠-葡萄糖协同转运蛋白2抑制剂与胰高血糖素样肽-1受体激动剂的心血管和肾脏结局比较:一项系统评价

Comparative Cardiovascular and Renal Outcomes of Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes: A Systematic Review.

作者信息

Khan Huzaifa K, Ashfaq Zarbakhta, Jamil Hamza, Yaqoob Hureem, Anthony Nouman, Dilawar Rimsha, Ahmad Bilal, Nabi Sadikun, Rania Sharmin Ahmed, Saleem Falaknaz, Gerges Marie, Mikhael Demiana M

机构信息

Medicine, Foundation University School of Health Sciences, Islamabad, PAK.

Medicine, Rehman Medical Institute, Peshawar, PAK.

出版信息

Cureus. 2025 Mar 21;17(3):e80932. doi: 10.7759/cureus.80932. eCollection 2025 Mar.

DOI:10.7759/cureus.80932
PMID:40255755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12009492/
Abstract

This systematic review evaluates the cardiovascular and renal outcomes associated with sodium-glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists in patients with type 2 diabetes, focusing on findings from randomized controlled trials. A comprehensive search was conducted across PubMed, Embase, and the Cochrane Library, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seven high-quality trials met the inclusion criteria, with a combined focus on major adverse cardiovascular events (MACE), heart failure hospitalizations, all-cause and cardiovascular mortality, and renal function decline. SGLT2 inhibitors demonstrated superior efficacy in reducing heart failure and renal outcomes, while GLP-1 receptor agonists were more effective in preventing MACE and improving glycemic control. Combination therapy showed potential additive benefits, particularly in improving myocardial and arterial function. The findings highlight the complementary roles of these drug classes, underscoring the importance of personalized therapy based on individual patient profiles. Further research, including long-term head-to-head trials, is warranted to validate these results and optimize treatment strategies.

摘要

本系统评价评估了2型糖尿病患者中,钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂与心血管和肾脏结局的相关性,重点关注随机对照试验的结果。按照系统评价和Meta分析的首选报告项目(PRISMA)指南,对PubMed、Embase和Cochrane图书馆进行了全面检索。七项高质量试验符合纳入标准,综合关注主要不良心血管事件(MACE)、心力衰竭住院、全因死亡率和心血管死亡率以及肾功能下降。SGLT2抑制剂在降低心力衰竭和肾脏结局方面显示出卓越疗效,而GLP-1受体激动剂在预防MACE和改善血糖控制方面更有效。联合治疗显示出潜在的附加益处,特别是在改善心肌和动脉功能方面。这些发现突出了这些药物类别的互补作用,强调了基于个体患者情况进行个性化治疗的重要性。有必要进行进一步研究,包括长期的头对头试验,以验证这些结果并优化治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc79/12009492/aa6ff1684444/cureus-0017-00000080932-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc79/12009492/aa6ff1684444/cureus-0017-00000080932-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc79/12009492/aa6ff1684444/cureus-0017-00000080932-i01.jpg

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本文引用的文献

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Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial.在 FLOW 试验中,有 2 型糖尿病和慢性肾病的参与者使用和不使用 SGLT2 抑制剂的司美格鲁肽的影响。
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Effects of Liraglutide, Empagliflozin and Their Combination on Left Atrial Strain and Arterial Function.
利拉鲁肽、恩格列净及其联合治疗对左心房应变和动脉功能的影响。
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