目錄/各期文章

內科學誌 -第34卷第5期

綜論 
Cardiorenal Protection of Sodium–Glucose Cotransporter-2 Inhibitors in Patients With Type 2 Diabetes: Clinical Studies to Real-World Evidence  全文閱讀
320~340 
英文 
Sodium–glucose cotransporter-2 inhibitors、 type 2 diabetes、cardiorenal protection、 heart failure、 cardiovascular disease、chronic kidney disease 
曾國賓  
義大癌治療醫院內科部內分泌暨新陳代謝科1 、義守大學醫學院2  
      Cardiovascular disease and chronic kidney disease (CKD) are the major causes of mortality in patients with type 2 diabetes (T2D) worldwide. Although intensive glucose control reduces vascular complications in patients with T2D, the increasing prevalence of diabetic cardiorenal disease has persisted globally. Drugs with the potential to halt progressive cardiorenal damage are urgently required. In addition to the glucose-lowering effect, sodium–glucose cotransporter-2 inhibitors (SGLT2is) exert pleotropic effects such as the reduction of blood pressure, weight loss, albuminuria improvement, anti-inflammatory and antifibrotic actions, with potential favorable effects on systemic and intrarenal hemodynamic pathways, thus providing a cardiorenal benefit. In particular, recent trials examining the cardiovascular and renal disease outcomes of SGLT2is treatment have reported that SGLT2is effectively prevented the incidence of worsening heart failure (HF), kidney disease progression, and mortality. These findings were further confirmed by randomized controlled trials conducted in patients with baseline HF and CKD, irrespective of the presence of diabetes, as well as real-world studies. Nevertheless, the effects of SGLT2is in patients with atherosclerotic cardiovascular events remain conflicting. This article reviews the proposed cardiorenal protection provided by this class of drugs by summarizing the evidence generated from clinical trials to real-world studies.