PDF(Pubmed)
Abstract：
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have many actions beyond glycemic control. The drug leads to favorable cardiovascular and renal outcomes. In this review, we focused on how SGLT2 inhibitors produce these outcomes and what role it plays in the inhibition of the sympathetic nervous system in diabetic patients. We searched PubMed, Google Scholar, and Biomed Central databases from January 2016 to February 2022. The authors used specific keywords and the Medical Subject Heading (MeSH) strategy. We identified a total of 3,961 records. Strict inclusion-exclusion criteria were followed to gather relevant data. From 3,961 results found through electronic databases, we finally selected 161 studies after the removal of duplicates, excluding irrelevant studies and those that did not fall into inclusion criteria. Forty-one studies underwent an extensive content search and quality appraisal using specific tools. It included a total of 12 best studies to conduct the systematic review supporting data from 17 other studies. Our review found that the SGLT2 inhibitors significantly reduced cardiovascular endpoints, including cardiovascular death, heart failure hospitalization, and all-cause mortality, with varying effects on major adverse cardiovascular (MACE). There were nominal improvements in renal outcomes (decline in renal disease progression, decreased albuminuria, less need for renal replacement therapy [RRT], and stable estimated glomerular filtration rate [eGFR]). Inhibition of the sympathetic nervous system (SNS) is an important and under-studied mechanism of SGLT2 inhibitors. This systematic review explores that SGLT2 inhibitors decrease the time to first cardiovascular event or death, less heart failure hospitalizations (HFH), and reduced MACE. Improvements in renal function preserved eGFR and reduction in RRT. Also, this drug inhibits SNS further by aiding in cardiorenal protection.
摘要：
钠-葡萄糖协同转运蛋白2（SGLT2）抑制剂具有许多超出血糖控制的作用。该药物导致有利的心血管和肾脏结果。在这次审查中,我们关注SGLT2抑制剂是如何产生这些结果的,以及它在抑制糖尿病患者的交感神经系统中起什么作用.我们搜索了PubMed,谷歌学者，和BiomedCentral数据库，从2016年1月到2022年2月。作者使用了特定的关键词和医学主题标题(MeSH)策略。我们确定了总共3,961条记录。严格的纳入-排除标准收集相关数据。从通过电子数据库找到的3,961个结果中，我们最终选择了161项删除重复项的研究，排除不相关研究和不属于纳入标准的研究.41项研究使用特定工具进行了广泛的内容搜索和质量评估。它包括总共12项最佳研究，以进行系统评价，支持其他17项研究的数据。我们的综述发现SGLT2抑制剂显著降低了心血管终点，包括心血管死亡,心力衰竭住院，和全因死亡率，对主要心血管不良(MACE)有不同的影响。肾脏结局有名义上的改善（肾脏疾病进展下降，蛋白尿减少，对肾脏替代疗法的需求减少[RRT]，和稳定的估计肾小球滤过率[eGFR])。抑制交感神经系统（SNS）是SGLT2抑制剂的重要且研究不足的机制。本系统综述探讨了SGLT2抑制剂减少首次心血管事件或死亡的时间。更少的心力衰竭住院（HFH），减少MACE。肾功能的改善保留了eGFR并降低了RRT。此外，该药物通过辅助心肾保护进一步抑制SNS。
