SGLT2 Inhibitors and How They Work Beyond the Glucosuric Effect. State of the Art

IF 2.8 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiovascular Drugs Pub Date : 2024-08-24 DOI:10.1007/s40256-024-00673-1

David Aristizábal-Colorado, Martín Ocampo-Posada, Wilfredo Antonio Rivera-Martínez, David Corredor-Rengifo, Jorge Rico-Fontalvo, Juan Esteban Gómez-Mesa, John Jairo Duque-Ossman, Alin Abreu-Lomba

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引用次数: 0

Abstract

Type 2 diabetes mellitus (T2DM) is associated with a heightened risk of cardiovascular and renal complications. While glycemic control remains essential, newer therapeutic options, such as SGLT2 inhibitors, offer additional benefits beyond glucose reduction. This review delves into the mechanisms underlying the cardio-renal protective effects of SGLT2 inhibitors. By inducing relative hypoglycemia, these agents promote ketogenesis, optimize myocardial energy metabolism, and reduce lipotoxicity. Additionally, SGLT2 inhibitors exert renoprotective actions by enhancing renal perfusion, attenuating inflammation, and improving iron metabolism. These pleiotropic effects, including modulation of blood pressure, reduction of uric acid, and improved endothelial function, collectively contribute to the cardiovascular and renal benefits observed with SGLT2 inhibitor therapy. This review will provide clinicians with essential knowledge, understanding, and a clear recollection of this pharmacological group’s mechanism of action.

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SGLT2 抑制剂及其在糖尿效应之外的作用。技术现状。

2 型糖尿病（T2DM）与心血管和肾脏并发症风险增加有关。虽然控制血糖仍然至关重要，但 SGLT2 抑制剂等较新的治疗选择可提供降糖以外的额外益处。本综述将深入探讨 SGLT2 抑制剂对心血管和肾脏具有保护作用的机制。通过诱导相对低血糖，这些药物可促进酮体生成、优化心肌能量代谢并降低脂毒性。此外，SGLT2 抑制剂还能通过增强肾脏灌注、减轻炎症和改善铁代谢来发挥肾脏保护作用。这些多效应，包括调节血压、降低尿酸和改善内皮功能，共同促成了 SGLT2 抑制剂治疗对心血管和肾脏的益处。本综述将为临床医生提供基本知识，帮助他们理解并清楚地记住该药理组的作用机制。

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来源期刊

American Journal of Cardiovascular Drugs 医学-心血管系统

CiteScore

6.70

自引率

3.30%

发文量

审稿时长

>12 weeks

期刊介绍： Promoting rational therapy within the discipline of cardiology, the American Journal of Cardiovascular Drugs covers all aspects of the treatment of cardiovascular disorders, particularly the place in therapy of newer and established agents. Via a program of reviews and original clinical research articles, the journal addresses major issues relating to treatment of these disorders, including the pharmacology, efficacy and adverse effects of the major classes of drugs; information on newly developed drugs and drug classes; the therapeutic implications of latest research into the aetiology of cardiovascular disorders; and the practical management of specific clinical situations. The American Journal of Cardiovascular Drugs offers a range of additional enhanced features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist patients, caregivers and others in understanding important medical advances. The journal also provides the option to include various other types of enhanced features including slide sets, videos and animations. All enhanced features are peer reviewed to the same high standard as the article itself. Peer review is conducted using Editorial Manager®, supported by a database of international experts. This database is shared with other Adis journals.