目的比较非奈利酮与钠-葡萄糖共转运蛋白-2(sodium-glucose cotransporter-2,SGLT2)抑制剂对2型糖尿病和/或慢性肾脏病患者心血管事件的影响。方法检索PubMed、Cochrane Library、Web of Science和Embase数据库关于2型糖尿病和/或慢性...目的比较非奈利酮与钠-葡萄糖共转运蛋白-2(sodium-glucose cotransporter-2,SGLT2)抑制剂对2型糖尿病和/或慢性肾脏病患者心血管事件的影响。方法检索PubMed、Cochrane Library、Web of Science和Embase数据库关于2型糖尿病和/或慢性肾脏病患者的随机对照试验,时间为建库至2023年7月3日。基于频率模型,使用STATA 17.0软件进行网状荟萃分析(network meta-analysis,NMA)。结果共纳入7项随机对照试验,包括33206例患者。涉及的治疗方式包括非奈利酮和SGLT2抑制剂,其中SGLT2抑制剂包含恩格列净、卡格列净、达格列净和索格列净(双重SGLT抑制剂)。在心血管复合事件方面,根据累计曲线下的概率面积(surface under the cumulative ranking area,SUCRA)排序,索格列净最有效。在心血管死亡方面,根据SUCRA排序,恩格列净最有效。在心力衰竭住院方面,根据SUCRA排序,卡格列净最有效。在全因死亡方面,根据SUCRA排序,达格列净最有效。非奈利酮和SGLT2抑制剂在不良事件、严重不良事件和急性肾损害的安全性方面比较,差异均无统计学意义(均P>0.05)。与采用非奈利酮治疗的患者相比,采用SGLT2抑制剂治疗的患者高钾血症发生率更低(RR=0.41,95%CI 0.32~0.52)。结论与非奈利酮相比,SGLT2抑制剂能更好地降低心血管事件的发生率,可作为2型糖尿病和/或慢性肾脏病患者的基础治疗,帮助预防或减少心血管事件。展开更多
目的采用CiteSpace软件可视化分析钠葡萄糖协同转运蛋白2(SGLT2)抑制剂治疗心力衰竭(HF)相关研究的文献篇数、发文作者、研究机构以及关键词,探索SGLT2抑制剂治疗HF的发展状况、研究热点及研究前沿。方法以Web of Science核心合集数据...目的采用CiteSpace软件可视化分析钠葡萄糖协同转运蛋白2(SGLT2)抑制剂治疗心力衰竭(HF)相关研究的文献篇数、发文作者、研究机构以及关键词,探索SGLT2抑制剂治疗HF的发展状况、研究热点及研究前沿。方法以Web of Science核心合集数据库为检索源,基于Java平台的文献计量学CiteSpace V软件对纳入的文献进行处理分析,并得出相关知识图谱。结果Web of Science数据库自1997年发布以来收录的关于SGLT2抑制剂治疗HF研究的英文文章最早发表于2012年,该领域发文数量从2012—2021年呈上升趋势,说明该领域仍处于发展阶段。本研究共纳入文献1051篇,美国共发文471篇,为该领域发文量最多的国家。发文数量最多的研究机构是加拿大的多伦多大学,各研究机构之间合作较少,且较为分散。可视化分析后得出该领域研究热点主要为糖尿病、心血管疾病及慢性肾病在SGLT2抑制剂治疗中的获益及其作用机制。结论该领域目前的研究热点之一是HF在运用SGLT2抑制剂治疗中的获益情况,逐步拓展到其他心血管疾病如房颤、心肌梗死等及慢性肾病患者在运用SGLT2抑制剂治疗中是否获益,这类药物可以改善糖尿病患者的预后、降低HF患者的死亡率、减少糖尿病患者肾功能衰竭的发生,并可以通过优化血容量起到一定的降压等作用,且目前只有SGLT2抑制剂具备以上多重功效。故推测,SGLT2抑制剂具有广阔的临床应用前景。展开更多
Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice we...Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice were divided into control group (13) and model group (53), and the model group was moulded by subcutaneous injection of D-galactose into the back of the neck, while the control group was treated with equal amount of saline for 8 weeks. The weight of each group of mice was observed and recorded every 7 days, and two groups of mice were randomly selected for frozen sections of brain tissue at the end of the modelling period to verify the aging model. 2. After the aging model was successfully established, the aging groups were divided into 5 groups: model group, dagliflozin-treated group (high and low dose), and dagliflozin + ex527-inhibited group (high and low dose). Fasting blood glucose was measured in each group every 2 weeks for 8 weeks. At the end of treatment, Morris water maze was performed at the end of the treatment. After execution of the mice, the organ indices of heart, brain, liver, kidney and spleen were measured;the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum were determined. Results: After the successful establishment of the aging model, it was found that during the treatment phase of dagliflozin. 1) The organ indices of mice in the aging group were significantly lower than those of other groups, and no significant hypoglycemia was observed throughout the treatment process. 2) In the water maze test, mice in the aging group had a significantly longer latency in the plateau phase compared to the control and treatment groups, while the number of times the mice crossed the original plateau and the percentage of time spent exploring the original plateau quadrant were reduced after the plateau was removed. 3) The nerve cells in the aging mice were disorganized and the nuclei of the mice were deeply stained;the dagliflozin group improved the morphological changes in the brain of aging mice. 4) In addition, compared with the control mice, the serum MDA level was significantly increased and the antioxidant enzyme SOD activity was significantly decreased in the aging group, while compared with the aging group, dagliflozin significantly decreased the MDA level and increased the SOD activity. 5) The expression of SIRT1 and PGC-1α was significantly upregulated in the low and high doses of dagliflozin compared to the aging group. Conclusion: The present study suggests that dagliflozin can delay organ aging, improve the learning and memory ability of aging mice, and exert antioxidant effects, probably through upregulating the SIRT1/PGC-1α signaling pathway.展开更多
文摘目的比较非奈利酮与钠-葡萄糖共转运蛋白-2(sodium-glucose cotransporter-2,SGLT2)抑制剂对2型糖尿病和/或慢性肾脏病患者心血管事件的影响。方法检索PubMed、Cochrane Library、Web of Science和Embase数据库关于2型糖尿病和/或慢性肾脏病患者的随机对照试验,时间为建库至2023年7月3日。基于频率模型,使用STATA 17.0软件进行网状荟萃分析(network meta-analysis,NMA)。结果共纳入7项随机对照试验,包括33206例患者。涉及的治疗方式包括非奈利酮和SGLT2抑制剂,其中SGLT2抑制剂包含恩格列净、卡格列净、达格列净和索格列净(双重SGLT抑制剂)。在心血管复合事件方面,根据累计曲线下的概率面积(surface under the cumulative ranking area,SUCRA)排序,索格列净最有效。在心血管死亡方面,根据SUCRA排序,恩格列净最有效。在心力衰竭住院方面,根据SUCRA排序,卡格列净最有效。在全因死亡方面,根据SUCRA排序,达格列净最有效。非奈利酮和SGLT2抑制剂在不良事件、严重不良事件和急性肾损害的安全性方面比较,差异均无统计学意义(均P>0.05)。与采用非奈利酮治疗的患者相比,采用SGLT2抑制剂治疗的患者高钾血症发生率更低(RR=0.41,95%CI 0.32~0.52)。结论与非奈利酮相比,SGLT2抑制剂能更好地降低心血管事件的发生率,可作为2型糖尿病和/或慢性肾脏病患者的基础治疗,帮助预防或减少心血管事件。
文摘目的采用CiteSpace软件可视化分析钠葡萄糖协同转运蛋白2(SGLT2)抑制剂治疗心力衰竭(HF)相关研究的文献篇数、发文作者、研究机构以及关键词,探索SGLT2抑制剂治疗HF的发展状况、研究热点及研究前沿。方法以Web of Science核心合集数据库为检索源,基于Java平台的文献计量学CiteSpace V软件对纳入的文献进行处理分析,并得出相关知识图谱。结果Web of Science数据库自1997年发布以来收录的关于SGLT2抑制剂治疗HF研究的英文文章最早发表于2012年,该领域发文数量从2012—2021年呈上升趋势,说明该领域仍处于发展阶段。本研究共纳入文献1051篇,美国共发文471篇,为该领域发文量最多的国家。发文数量最多的研究机构是加拿大的多伦多大学,各研究机构之间合作较少,且较为分散。可视化分析后得出该领域研究热点主要为糖尿病、心血管疾病及慢性肾病在SGLT2抑制剂治疗中的获益及其作用机制。结论该领域目前的研究热点之一是HF在运用SGLT2抑制剂治疗中的获益情况,逐步拓展到其他心血管疾病如房颤、心肌梗死等及慢性肾病患者在运用SGLT2抑制剂治疗中是否获益,这类药物可以改善糖尿病患者的预后、降低HF患者的死亡率、减少糖尿病患者肾功能衰竭的发生,并可以通过优化血容量起到一定的降压等作用,且目前只有SGLT2抑制剂具备以上多重功效。故推测,SGLT2抑制剂具有广阔的临床应用前景。
文摘Objective: To observe the cerebral protective effect of dagliflozin, a sodium-glucose co-transport protein 2 (SGLT2) inhibitor, in aging mice and to explore its molecular mechanism. Methods: 1. 66 male C57BL/6 mice were divided into control group (13) and model group (53), and the model group was moulded by subcutaneous injection of D-galactose into the back of the neck, while the control group was treated with equal amount of saline for 8 weeks. The weight of each group of mice was observed and recorded every 7 days, and two groups of mice were randomly selected for frozen sections of brain tissue at the end of the modelling period to verify the aging model. 2. After the aging model was successfully established, the aging groups were divided into 5 groups: model group, dagliflozin-treated group (high and low dose), and dagliflozin + ex527-inhibited group (high and low dose). Fasting blood glucose was measured in each group every 2 weeks for 8 weeks. At the end of treatment, Morris water maze was performed at the end of the treatment. After execution of the mice, the organ indices of heart, brain, liver, kidney and spleen were measured;the levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in serum were determined. Results: After the successful establishment of the aging model, it was found that during the treatment phase of dagliflozin. 1) The organ indices of mice in the aging group were significantly lower than those of other groups, and no significant hypoglycemia was observed throughout the treatment process. 2) In the water maze test, mice in the aging group had a significantly longer latency in the plateau phase compared to the control and treatment groups, while the number of times the mice crossed the original plateau and the percentage of time spent exploring the original plateau quadrant were reduced after the plateau was removed. 3) The nerve cells in the aging mice were disorganized and the nuclei of the mice were deeply stained;the dagliflozin group improved the morphological changes in the brain of aging mice. 4) In addition, compared with the control mice, the serum MDA level was significantly increased and the antioxidant enzyme SOD activity was significantly decreased in the aging group, while compared with the aging group, dagliflozin significantly decreased the MDA level and increased the SOD activity. 5) The expression of SIRT1 and PGC-1α was significantly upregulated in the low and high doses of dagliflozin compared to the aging group. Conclusion: The present study suggests that dagliflozin can delay organ aging, improve the learning and memory ability of aging mice, and exert antioxidant effects, probably through upregulating the SIRT1/PGC-1α signaling pathway.
