钠-葡萄糖共转运体-2 抑制剂对心血管和肾脏有益的临床证据和拟议机制。

TouchREVIEWS in endocrinology Pub Date : 2022-11-01 Epub Date: 2022-11-29 DOI:10.17925/EE.2022.18.2.106
Joshua J Neumiller, Fredrick J Lienhard, Radica Z Alicic, Katherine R Tuttle
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引用次数: 0

摘要

全球 2 型糖尿病(T2D)患者及其并发症的人数正以惊人的速度增长。幸运的是,我们对钠-葡萄糖共转运体-2(SGLT2)抑制剂和胰高血糖素样肽-1(GLP-1)受体激动剂类降糖药物对心血管和肾脏功能的益处有了更深入的了解;这意味着我们现在有了新的选择来降低 T2D 患者出现这些并发症的风险。在专门的结果试验中,SGLT2 抑制剂已持续显示出对动脉粥样硬化性心血管疾病(ASCVD)、慢性肾脏疾病(CKD)和心力衰竭(HF)事件的益处。目前,大型指南小组推荐将 SGLT2 抑制剂作为并发 ASCVD、CKD 和/或 HF 的 T2D 患者的标准治疗方法。不断发展的证据还表明,SGLT2 抑制剂对无糖尿病人群的肾脏和心房颤动也有益处。这些药物可能通过多种机制为心脏和肾脏带来益处,因为它们对心脏和肾脏预后的影响不能完全通过其直接代谢作用来解释。目前正在进行的阐明 SGLT2 抑制剂获益机制的工作将有助于进一步优化这些拯救糖尿病患者和非糖尿病患者生命的疗法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Clinical Evidence and Proposed Mechanisms for Cardiovascular and Kidney Benefits from Sodium-Glucose Co-transporter-2 Inhibitors.

The number of people living with type 2 diabetes (T2D) and its complications worldwide is increasing at an alarming rate. Fortunately, our understanding of the benefits of glucose-lowering agents from the sodium-glucose co-transporter-2 (SGLT2) inhibitor and glucagon-like peptide-1 (GLP-1) receptor agonist classes on cardiovascular and kidney outcomes is advancing; this means we now have new options to mitigate the risks of these complications in patients with T2D. The SGLT2 inhibitors have consistently demonstrated benefits on atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD) and heart failure (HF) events in dedicated outcome trials. Large guidelines groups now recommend SGLT2 inhibitors as a standard of care in patients with T2D and comorbid ASCVD, CKD and/ or HF. Evolving evidence additionally indicates kidney and HF benefits of SGLT2 inhibitors in populations without diabetes. These agents likely provide heart and kidney benefits through multiple mechanisms, as their impact on heart and kidney outcomes cannot be fully explained by their direct metabolic effects. On-going work to elucidate the beneficial mechanisms at play with SGLT2 inhibitors will help further optimize these life-saving therapies in patients with and without T2D.

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