Sodium-Glucose Cotransporter 2 Inhibitors and Changes in Epicardial Adipose Tissue: A Systematic Literature Review And Meta-Analysis.

IF 2.8 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Current vascular pharmacology Pub Date : 2025-01-15 DOI:10.2174/0115701611330060241204062248

Panagiotis Theofilis, Evangelos Oikonomou, Panayotis K Vlachakis, Paschalis Karakasis, Kyriakos Dimitriadis, Marios Sagris, Konstantinos Pamporis, Maria Drakopoulou, Gerasimos Siasos, Konstantinos Tsioufis, Dimitris Tousoulis

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引用次数: 0

Abstract

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a groundbreaking class of antidiabetic medications renowned for their glucose-lowering effects and cardiovascular benefits. Recent studies have suggested that SGLT2 inhibitors may extend their influence beyond glycemic control to impact adipose tissue physiology, particularly within the epicardial adipose depot. Epicardial adipose tissue (EAT), an actively secretory organ surrounding the heart, has been implicated in the modulation of cardiovascular risk.

Aims: This systematic review and meta-analysis aims to systematically review and synthesize existing literature on the effects of SGLT2 inhibitors on EAT.

Methods: We performed a literature search for studies assessing the changes in epicardial adipose tissue volume/thickness before and after treatment with an SGLT2 inhibitor. We excluded reviews, editorials, case reports/case series, experimental studies, and studies that did not use SGLT2 inhibitors as the intervention. The main outcome of interest was the change in EAT volume/thickness at follow-up.

Results: The literature search yielded 72 results. After the application of the exclusion criteria, a total of 11 studies were selected for data extraction and inclusion in the meta-analysis. A mean of 6.57ml decreased EAT volume, and EAT thickness was reduced by a mean of 1.55mm. We detected that treatment with an SGLT2 inhibitor was associated with decreased EAT volume/thickness compared to the control group (SMD -1.79, 95% CI -2.91 to -0.66, p<0.01). There was substantial betweenstudy heterogeneity (I2: 94%, p<0.001). Results remained robust even after the exclusion of any single study. Subgroup analysis revealed a significantly greater effect size in randomized studies. Funnel plot inspection and Egger's regression test did not indicate the presence of publication bias Conclusion: This meta-analysis suggests that SGLT2 inhibitors use is associated with a reduction in EAT volume/thickness, posing as a potential mechanism of their beneficial effects in heart failure outcomes.

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钠-葡萄糖共转运蛋白2抑制剂和心外膜脂肪组织的变化：系统文献综述和荟萃分析。

钠-葡萄糖共转运蛋白2 （SGLT2）抑制剂已成为一类开创性的抗糖尿病药物，以其降血糖作用和心血管益处而闻名。最近的研究表明，SGLT2抑制剂可能将其影响扩展到血糖控制以外的脂肪组织生理学，特别是在心外膜脂肪库中。心外膜脂肪组织（EAT）是心脏周围的一个活跃的分泌器官，与心血管风险的调节有关。目的：本系统综述和荟萃分析旨在系统回顾和综合现有关于SGLT2抑制剂对EAT影响的文献。方法：我们进行了文献检索，以评估SGLT2抑制剂治疗前后心外膜脂肪组织体积/厚度的变化。我们排除了综述、社论、病例报告/病例系列、实验研究和未使用SGLT2抑制剂作为干预措施的研究。关注的主要结果是随访时EAT体积/厚度的变化。结果：文献检索结果72条。应用排除标准后，共选择11项研究进行数据提取并纳入meta分析。平均6.57ml减少EAT体积，平均1.55mm减少EAT厚度。我们发现，与对照组相比，使用SGLT2抑制剂治疗与EAT体积/厚度减少相关(SMD -1.79, 95% CI -2.91至-0.66,p

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来源期刊

Current vascular pharmacology 医学-外周血管病

CiteScore

9.20

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Vascular Pharmacology publishes clinical and research-based reviews/mini-reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research. Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).