The current role of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes mellitus management.
The current role of sodium-glucose cotransporter 2 inhibitors in type 2 diabetes mellitus management.
复制标题
钠-葡萄糖协同转运蛋白2抑制剂在2型糖尿病治疗中的作用。
DOI：
10.1186/s12933-022-01512-w
复制
发表时间：
2022-05-25
影响因子：
9.3
通讯作者：
中科院分区：
文献类型：
--
作者：
2型糖尿病(T2 DM)是一种慢性复杂的代谢性疾病，其特征是由于胰岛素抵抗或胰岛素分泌缺陷而导致的胰岛素信号不充分引起的慢性高血糖，并可导致严重的并发症和过早死亡。钠-葡萄糖共转运体-2(SGLT2)抑制剂是用于降低T2 DM患者高血糖的口服药物，包括依帕格列酮、厄尔格列芬、达帕格列酮和卡那格列酮。这篇文章的主要目的是检查美国FDA批准的四种SGLT2受体抑制剂的临床益处、安全性和耐受性。SGLT2抑制剂通过抑制SGLT2来增加尿糖排泄，从而减少肾脏对过滤葡萄糖的重吸收，降低肾脏对葡萄糖的阈值。SGLT2抑制剂不是刺激胰岛素释放，而是通过改善糖毒性来改善β细胞的功能，以及降低胰岛素抵抗和增加胰岛素敏感性。早期临床试验已经证实SGLT2对T2 DM的有益效果，安全性可接受，耐受性良好。近年来，SGLT2抑制剂已先后被FDA批准用于减少心血管死亡，降低已被诊断为心血管疾病的T2 DM成年人中风和心脏病发作的风险，治疗射血分数降低的心力衰竭(HF)和保留射血分数的HF，以及治疗糖尿病肾病(DKD)，降低T2 DM和DKD患者因HF住院的风险。SGLT2抑制剂有望成为治疗2型糖尿病合并非酒精性脂肪性肝病的有效药物。SGLT2抑制剂与安慰剂或其他积极对照组的安全性相似，有主要不良事件，如酮症酸中毒或低血压以及生殖器或尿路感染。
Type 2 diabetes mellitus (T2DM) is a chronic, complex metabolic disease characterized by chronic hyperglycemia causing from insufficient insulin signaling because of insulin resistance or defective insulin secretion, and may induce severe complications and premature death. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are oral drugs used to reduce hyperglycemia in patients with T2DM, including empagliflozin, ertugliflozin, dapagliflozin and canagliflozin. The primary objective of this article is to examine the clinical benefit, safety, and tolerability of the four SGLT2 inhibitors approved by the US FDA. SGLT2 inhibitors increase urinary glucose excretion via inhibiting SGLT2 to decrease renal reabsorption of filtered glucose and reduce the renal threshold for glucose. Rather than stimulating insulin release, SGLT2 inhibitors improve β-cell function by improving glucotoxicity, as well as reduce insulin resistance and increase insulin sensitivity. Early clinical trials have confirmed the beneficial effects of SGLT2 in T2DM with acceptable safety and excellent tolerability. In recent years, SGLT2 inhibitors has been successively approved by the FDA to decrease cardiovascular death and decrease the risk of stroke and cardiac attack in T2DM adults who have been diagnosed with cardiovascular disease, treating heart failure (HF) with reduced ejection fraction and HF with preserved ejection fraction, and treat diabetic kidney disease (DKD), decrease the risk of hospitalization for HF in T2DM and DKD patients. SGLT2 inhibitors are expected to be an effective treatment for T2DM patients with non alcoholic fatty liver disease. SGLT2 inhibitors have a similar safety profile to placebo or other active control groups, with major adverse events such as Ketoacidosis or hypotension and genital or urinary tract infections.
登录
查看更多内容
影响因子：
8.2
作者：
Eriksson JW;Lundkvist P;Jansson PA;Johansson L;Kvarnström M;Moris L;Miliotis T;Forsberg GB;Risérus U;Lind L;Oscarsson J
通讯作者：
Oscarsson J
影响因子：
2.1
作者：
Enigk, Uta;Breitfeld, Jana;Toenjes, Anke
通讯作者：
Toenjes, Anke
影响因子：
18.2
作者：
Dewan P;Docherty KF;Bengtsson O;de Boer RA;Desai AS;Drozdz J;Hawkins NM;Inzucchi SE;Kitakaze M;Køber L;Kosiborod MN;Langkilde AM;Lindholm D;Martinez FA;Merkely B;Petrie MC;Ponikowski P;Sabatine MS;Schou M;Sjöstrand M;Solomon SD;Verma S;Jhund PS;McMurray JJV
通讯作者：
McMurray JJV
影响因子：
44.5
作者：
Barnett, Anthony H.;Mithal, Ambrish;Broedl, Uli C.
通讯作者：
Broedl, Uli C.
影响因子：
4
作者：
Drexel, Heinz;Leiherer, Andreas;Muendlein, Axel
通讯作者：
Muendlein, Axel