钠-葡萄糖共转运蛋白2抑制剂作为一种强大的心脏保护和肾保护工具:临床试验和机制综述

IF 2.4 Q3 ENDOCRINOLOGY & METABOLISM Diabetology Pub Date : 2023-07-04 DOI:10.3390/diabetology4030022
Andrej Belančić, Sanja Klobučar
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引用次数: 2

摘要

根据大量文献,钠-葡萄糖共转运蛋白2 (SGLT2)抑制剂与心血管危险因素、血压、体重和血脂的有益影响有关。在随后的大型心血管结局试验中,使用SGLT2抑制剂在2型糖尿病患者以及心力衰竭和/或慢性肾脏疾病(CKD)患者中显示出显著的心脏和肾脏益处,无论糖尿病状态如何。因此,SGLT2抑制剂由于其对心脏和肾脏的益处,已成为2型糖尿病合并心血管疾病和CKD患者的主要治疗方法。基于随机对照试验和荟萃分析的数据,本文试图对SGLT2抑制剂的作用机制以及对心脏和肾脏保护的益处进行全面回顾。基于越来越多关于糖尿病和其他疾病的文献,临床实践指南已经更新,建议在特定患者群体中使用SGLT2抑制剂。这些修改也将根据循证医学原则进行简明描述。
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Sodium-Glucose Co-Transporter 2 Inhibitors as a Powerful Cardioprotective and Renoprotective Tool: Overview of Clinical Trials and Mechanisms
Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been linked to beneficial effects on cardiovascular risk factors, blood pressure, body weight, and lipid profile, according to a substantial body of literature. Significant cardiac and renal benefits with the use of SGLT2 inhibitors have been shown in patients with type 2 diabetes, as well as in those with heart failure and/or chronic kidney disease (CKD), regardless of diabetes status, in subsequent large cardiovascular outcome trials. Thus, SGLT2 inhibitors have become a mainstay of therapy for type 2 diabetes in patients with established cardiovascular disease and CKD due to their benefits for the heart and kidneys. Based on data from randomized controlled trials and meta-analyses, this article attempts to present a thorough review of the mechanism of action, as well as the benefits of SGLT2 inhibitors for cardiac and renal protection. On the basis of a growing body of literature on diabetes and other conditions, clinical practice guidelines have been updated to suggest the use of SGLT2 inhibitors in specific patient populations. These modifications will also be concisely described, based on evidence-based medicine principles.
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