SGLT2抑制剂对肾脏和心血管功能的影响。

IF 15.7 1区 医学 Q1 PHYSIOLOGY
Volker Vallon, Subodh Verma
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引用次数: 136

摘要

SGLT2抑制剂是一种抗高血糖药物,可以保护患有或不患有2型糖尿病的患者的肾脏和心脏,并保护或减少肾功能免于衰竭。所涉及的保护机制包括血糖依赖性和非依赖性机制:SGLT2抑制剂可预防高血糖和低血糖,预期对HbA1C的净影响很小。代谢适应诱导尿糖丢失包括减少脂肪量和更多的酮体作为额外的燃料。SGLT2抑制剂降低肾小球毛细血管高血压和超滤,从而减少滤过屏障的物理应激、蛋白尿和小管重吸收的需氧量。这可以改善皮质氧合,同时减少肾小管糖毒性,可以长期保持肾小管功能和肾小球滤过率。SGLT2抑制剂可能模拟全身缺氧并刺激红细胞生成,从而改善器官供氧。SGLT2抑制剂是近端小管和渗透性利尿剂,可减少体积潴留和血压,并保持心脏功能,部分可能是通过克服对利尿剂和心房钠尿肽的耐药性,抑制Na-H交换物和交感神经张力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of SGLT2 Inhibitors on Kidney and Cardiovascular Function.

SGLT2 inhibitors are antihyperglycemic drugs that protect kidneys and the heart of patients with or without type 2 diabetes and preserved or reduced kidney function from failing. The involved protective mechanisms include blood glucose-dependent and -independent mechanisms: SGLT2 inhibitors prevent both hyper- and hypoglycemia, with expectedly little net effect on HbA1C. Metabolic adaptations to induced urinary glucose loss include reduced fat mass and more ketone bodies as additional fuel. SGLT2 inhibitors lower glomerular capillary hypertension and hyperfiltration, thereby reducing the physical stress on the filtration barrier, albuminuria, and the oxygen demand for tubular reabsorption. This improves cortical oxygenation, which, together with lesser tubular gluco-toxicity, may preserve tubular function and glomerular filtration rate in the long term. SGLT2 inhibitors may mimic systemic hypoxia and stimulate erythropoiesis, which improves organ oxygen delivery. SGLT2 inhibitors are proximal tubule and osmotic diuretics that reduce volume retention and blood pressure and preserve heart function, potentially in part by overcoming the resistance to diuretics and atrial-natriuretic-peptide and inhibiting Na-H exchangers and sympathetic tone.

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来源期刊
Annual review of physiology
Annual review of physiology 医学-生理学
CiteScore
35.60
自引率
0.00%
发文量
41
期刊介绍: Since 1939, the Annual Review of Physiology has been highlighting significant developments in animal physiology. The journal covers diverse areas, including cardiovascular physiology, cell physiology, ecological, evolutionary, and comparative physiology, endocrinology, gastrointestinal physiology, neurophysiology, renal and electrolyte physiology, respiratory physiology, and special topics.
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