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钠-葡萄糖协同转运蛋白2抑制剂用于抗癌治疗患者的疗效与安全性：队列研究的荟萃分析

The Efficacy and Safety of Sodium Glucose Cotransporter 2 Inhibitors for Patients with Anticancer Therapy: A Meta-Analysis of Cohort Studies.

作者信息

Fan Gang, Zuo Hong, Lin Lin, Xu Chao, Yan Rui

机构信息

Cardiology Department of Xianyang Central Hospital, Xianyang, Shaanxi Province, 712000, PR China.

Cardiovascular Hospital of the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710016, PR China.

出版信息

Glob Heart. 2025 Jun 16;20(1):53. doi: 10.5334/gh.1440. eCollection 2025.

DOI:10.5334/gh.1440
PMID:40547873
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12180433/
Abstract

BACKGROUND

Chemotherapy-induced cardiotoxicity is the leading cause of non-tumor-related mortality among patients with tumors. Although sodium glucose cotransporter 2 inhibitors (SGLT2is) have been shown to confer cardiovascular benefits, their effects and safety profile in patients with cancer remain uncertain. The objective of this study was to assess the cardiovascular effects of SGLT2is in patients with cancer.

OBJECTIVE

We conducted a meta-analysis of cohort studies to compare the efficacy and safety of SGLT2is and placebo in patients with cancer.

RESULTS

A total of ten cohort studies, encompassing 85,185 patients, were included in this study. SGLT2is significantly decreased mortality (Risk ratios (RR) 0.52, 95% confidence interval (CI) (0.36, 0.75), I = 98%), heart failure (HF) (RR 0.43, 95% CI 0.24, 0.77, = 75%), and arrhythmia (RR 0.33, 95% CI 0 .23, 0.49, I = 0%). In addition, SGLT2is decreased the incidence of adverse events. No significant difference was identified in hypoglycemia, ketoacidosis, and acute coronary syndrome (ACS).

CONCLUSION

The present study suggest that sodium glucose cotransporter 2 inhibitors may be an efficacious and safe means for improving the prognosis of patients with cancer and diabetes. However, future large-scale randomized controlled trials are needed to further validate the results.

摘要

背景

化疗引起的心脏毒性是肿瘤患者非肿瘤相关死亡的主要原因。尽管已证明钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）具有心血管益处，但其在癌症患者中的作用和安全性仍不确定。本研究的目的是评估SGLT2i对癌症患者的心血管影响。

目的

我们对队列研究进行了荟萃分析，以比较SGLT2i与安慰剂在癌症患者中的疗效和安全性。

结果

本研究共纳入10项队列研究，涉及85185例患者。SGLT2i显著降低了死亡率（风险比（RR）0.52，95%置信区间（CI）（0.36，0.75），I² = 98%）、心力衰竭（HF）（RR 0.43，95% CI 0.24，0.77，I² = 75%）和心律失常（RR 0.33，95% CI 0.23，0.49，I² = 0%）。此外，SGLT2i降低了不良事件的发生率。在低血糖、酮症酸中毒和急性冠状动脉综合征（ACS）方面未发现显著差异。

结论

本研究表明，钠-葡萄糖协同转运蛋白2抑制剂可能是改善癌症合并糖尿病患者预后的一种有效且安全的方法。然而，未来需要大规模随机对照试验来进一步验证结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/295a1481a1c0/gh-20-1-1440-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/ac505c8cfe25/gh-20-1-1440-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/a796b979b941/gh-20-1-1440-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/fb152f07b7ec/gh-20-1-1440-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/760e45b62430/gh-20-1-1440-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/295a1481a1c0/gh-20-1-1440-g5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/ac505c8cfe25/gh-20-1-1440-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/a796b979b941/gh-20-1-1440-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/fb152f07b7ec/gh-20-1-1440-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/760e45b62430/gh-20-1-1440-g4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3076/12180433/295a1481a1c0/gh-20-1-1440-g5.jpg

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本文引用的文献

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Future Cardiol. 2024;20(7-8):395-407. doi: 10.1080/14796678.2024.2363673. Epub 2024 Jul 4.
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Exploring the anti-cancer potential of SGLT2 inhibitors in breast cancer treatment in pre-clinical and clinical studies.在临床前和临床研究中探索SGLT2抑制剂在乳腺癌治疗中的抗癌潜力。
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Cardiovascular outcomes associated with SGLT2 inhibitor therapy in patients with type 2 diabetes mellitus and cancer: a systematic review and meta-analysis.
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Diabetol Metab Syndr. 2024 May 22;16(1):108. doi: 10.1186/s13098-024-01354-4.
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Cardioprotective Potential of Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Cancer Treated With Anthracyclines: An Observational Study.钠-葡萄糖共转运蛋白-2 抑制剂在接受蒽环类药物治疗的癌症患者中的心脏保护作用：一项观察性研究。
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