SGLT2 Inhibitors: Benefits for CKD and Cardiovascular Disease in Type 2 Diabetes

Singhal, Ritu; Hechanova, Lisa Aimee

doi:10.1007/s11886-022-01637-0

Cited by 5 publications

(5 citation statements)

References 43 publications

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“…Several drugs (e.g., lipid-lowering and antidiabetic) that are not used to treat hyperuricemia may have some UA-lowering effect. 38,39 Besides, loop diuretics, thiazide diuretics, and low doses of asprin may increase UA levels. 40 Use of these drugs may have affected our results.…”

Section: Limitationsmentioning

confidence: 99%

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Yalcinkaya¹,

Karacali²,

Ilhan³

et al. 2023

Angiology

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Uric acid (UA) to albumin ratio (UAR) is an emerging marker to predict coronary artery disease (CAD)-related events. There is limited data on the relationship between UAR and the severity of the disease in chronic CAD patients. We aimed to evaluate UAR as an indicator for CAD severity using the Syntax score (SS). We retrospectively enrolled 558 patients with stable angina pectoris and underwent coronary angiography (CAG). Patients were divided into 2 groups, according to CAD severity: low SS (≤22) and intermediate-high SS (>22) groups. UA levels were higher and albumin levels were lower in the intermediate-high SS score group ( P < .001). UAR levels were significantly higher in the intermediate-high SS group ( P < .001). Also, there was a significant correlation between UAR levels and SS (r = .55, 95% confidence interval (CI): .49–.60, P < .001). In multivariable analysis, UAR >1.34 (Odds ratio, 3.8 [2.3–6.2]; P < .001) was an independent predictor of intermediate-high SS while albumin and UA levels were not. In conclusion, UAR predicted disease burden in chronic CAD patients. It may prove useful as a simple and readily available marker to select patients for further evaluation.

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Section: Limitationsmentioning

confidence: 99%

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Yalcinkaya¹,

Karacali²,

Ilhan³

et al. 2023

Angiology

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“…It is also worth mentioning that there are several drugs (e.g. lipid-lowering and antidiabetic) that are not used to treat hyperuricaemia but that may have some uric acid lowering effect, which, in turn, may be relevant in terms of CVD risk [22,23].…”

Section: Uric Acid and Cardiovascular Riskmentioning

confidence: 99%

Are serum uric acid levels predictors of cardiovascular risk? An update

Georgoulis

Mikhailidis

Panagiotakos

2023

Current Opinion in Cardiology

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Purpose of reviewThe aim of this review was to update the evidence regarding the link between serum uric acid and cardiovascular risk, as well as the role of nutrition in the prevention and management of hyperuricaemia.Recent findingsThe review focuses on recent epidemiological evidence concerning the role of elevated serum uric acid levels in cardiovascular risk prediction. The dietary prevention and management of hyperuricaemia is also discussed with an emphasis on the adoption of prudent dietary patterns.SummaryThere is evidence supporting that elevated serum uric acid levels are positively associated with cardiovascular disease risk and might represent a useful additional marker for risk stratification. The association of serum uric acid with all-cause and cardiovascular mortality seems to be U-shaped, suggesting that both very low and very high serum uric acid levels might be detrimental for survival, the former being mediated by malnutrition. Apart from medication, the dietary management of hyperuricaemia should focus on the adoption of a prudent dietary pattern, such as the Mediterranean diet, which can both prevent gout and mitigate cardiometabolic risk.

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“…The available agents share similar pharmacokinetic properties such as long half-life and rapid oral absorption, which allows once-daily administration, low renal elimination and the lack of clinically significant drugdrug interactions [10]. The SGLT-2 inhibitors bind to the co-transporters at the luminal surface of the proximal tubule with stronger affinity than glucose molecules and therefore prevent sodium and glucose reabsorption, which reduces serum glucose and haemoglobin A1c (HbA1c) levels, and also, has a diuretic effect due to natriuresis and osmotic diuresis [3,25,65]. The consequent glycosuria reduces mean plasma glucose levels and decreases glucotoxicity, which improves beta-cell function and insulin sensitivity.…”

Section: Summarizing the Beneficial Effects Of Sglt-2 Inhibitorsmentioning

confidence: 99%

New Directions in Pharmacological Treatment With SGLT-2 Inhibitor Molecules in the Light of Current Guidelines for Diabetes Mellitus, Heart Failure and Kidney Disease

TILINCA

2023

FARMACIA

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Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, a newer class of oral anti-hyperglycaemic agents, have been shown to improve cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM), by reducing the risk of heart failure, cardiovascular death, and renal events. This review aimed to describe the mechanism of action and clinical benefits of SGLT-2 inhibitors, highlighting their cardiorenal protection, glucose lowering effects, and their efficacy in the management of T2DM with multiple risk factors. SGLT-2 inhibitors reduce the reabsorption of sodium and glucose from the proximal tubules, thereby increasing renal glucose and sodium excretion. In addition to their glucose-lowering property, the clinical benefits of SGLT-2 inhibitors involve weight loss and major cardio-and reno-protective effects such as decreased preload and afterload, reversed cardiac remodelling, improved endothelial function, reduced albuminuria, improved glomerular hemodynamic and preserved kidney function. Therefore, SGLT2 inhibitors are a crucial component of management guidelines for diabetes, heart failure and chronic kidney disease, even in those without T2DM. RezumatInhibitorii co-transportorului 2 de sodiu-glucoză (SGLT-2), o nouă clasă de agenți antihiperglicemianți cu administrare orală, au demonstrat îmbunătățirea rezultatelor cardiovasculare și renale la pacienți cu diabet zaharat (DZ) tip 2, prin reducerea riscului de insuficiență cardiacă, deces de origine cardiovasculară și complicații renale. Acest articol își propune descrierea mecanismului de acțiune și a beneficiilor clinice ale inhibitorilor de SGLT-2, evidențiind efectele lor protectoare cardiorenale și de scădere a glicemiei, precum și eficacitatea lor în managementul DZ tip 2 cu multipli factori de risc. Inhibitorii de SGLT-2 reduc reabsorbția sodiului și glucozei din tubii contorți proximali, crescând astfel excreția renală de glucoză și sodiu. Pe lângă scăderea glicemiei, beneficiile clinice ale inhibitorilor de SGLT-2 includ scăderea în greutate și efecte cardio-și renoprotectoare, precum scăderea presarcinii și postsarcinii cardiace, inversarea remodelării cardiace majore, îmbunătățirea funcției endoteliale, reducerea albuminuriei, ameliorarea hemodinamicii glomerulare și menținerea funcției renale. Astfel, inhibitorii de SGLT-2 reprezintă un pilon extrem de important al ghidurilor de management, atât pentru diabetul zaharat, cât și pentru insuficiența cardiacă și boala renală cronică, chiar și la cei fără DZ tip 2.

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SGLT2 Inhibitors: Benefits for CKD and Cardiovascular Disease in Type 2 Diabetes

Cited by 5 publications

References 43 publications

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Relation Between Serum Uric Acid to Albumin Ratio and Severity of Chronic Coronary Artery Disease

Are serum uric acid levels predictors of cardiovascular risk? An update

New Directions in Pharmacological Treatment With SGLT-2 Inhibitor Molecules in the Light of Current Guidelines for Diabetes Mellitus, Heart Failure and Kidney Disease

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