心血管-肾脏-代谢综合征时代的新型心脏代谢药物。

Neal Pohlman, Prem N Patel, Utibe R Essien, Jasmyn J Tang, Joshua J Joseph
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摘要

心血管-肾代谢(CKM)综合征是肥胖、高血压、高脂血症、2型糖尿病(T2DM)、慢性肾脏疾病(CKD)和心血管疾病(CVD)的复杂相互作用,导致发病率和死亡率升高。CKM综合征包括一系列与肥胖、血糖调节受损和慢性炎症相关的代谢、肾脏和心血管功能障碍。本文综述了近年来有关钠-葡萄糖共转运蛋白2抑制剂(SGLT2-i)和胰高血糖素样肽-1受体激动剂(GLP1-RA)等心肾保护药物在CKM综合征治疗中的疗效的文献。SGLT2i药物显示出有希望的结果,包括降低心血管死亡率、心力衰竭住院和不同患者群体的不良肾脏事件,无论T2DM状态如何。同样,GLP-1RA药物在减肥、血糖控制和减少心血管和肾脏事件方面显示出实质性的益处。该综述还强调了公平的药物治疗分配的必要性,以确保高风险人群从这些进步中受益,并需要进一步的基于精确的治疗框架、政策创新和针对CKM综合征管理的量身定制的干预措施。最后,我们讨论了将这些发现转化为实践的策略,通过以股权为中心的视角来促进CKM健康。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Novel Cardiometabolic Medications in the Cardiovascular-Kidney-Metabolic Syndrome Era.

Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay of obesity, hypertension, hyperlipidemia, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD), driving elevated morbidity and mortality. CKM syndrome encompasses a continuum of interrelated metabolic, renal, and cardiovascular dysfunctions attributed to obesity, impaired glucose regulation, and chronic inflammation. This review synthesizes recent literature on the efficacy of cardiorenal protective medications including sodium-glucose cotransporter 2 inhibitors (SGLT2-i) and glucagon-like peptide-1 receptor agonists (GLP1-RA) in CKM syndrome management. SGLT2i agents show promising outcomes, including reduced cardiovascular mortality, hospitalization for heart failure, and adverse kidney events across diverse patient populations, regardless of T2DM status. Similarly, GLP-1RA agents demonstrate substantial benefits in weight loss, glycemic control, and reduced cardiovascular and kidney events. The review also highlights the necessity of equitable pharmacotherapy distribution to ensure that high-risk populations benefit from these advancements and the need for further precision-based therapeutic frameworks, policy innovations, and tailored interventions focused on CKM syndrome management. Finally, we discuss strategies for translating these findings into practice through an equity-focused lens to advance CKM health.

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