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
Cancer frequently develops resistance to the majority of chemotherapy treatments.This study aimed to examine the synergistic cytotoxic and antitumor effects of SGLT2 inhibitors,specifically Canagliflozin(CAN),Dapaglif...Cancer frequently develops resistance to the majority of chemotherapy treatments.This study aimed to examine the synergistic cytotoxic and antitumor effects of SGLT2 inhibitors,specifically Canagliflozin(CAN),Dapagliflozin(DAP),Empagliflozin(EMP),and Doxorubicin(DOX),using in vitro experimentation.The precise combination of CAN+DOX has been found to greatly enhance the cytotoxic effects of doxorubicin(DOX)in MCF-7 cells.Interestingly,it was shown that cancer cells exhibit an increased demand for glucose and ATP in order to support their growth.Notably,when these medications were combined with DOX,there was a considerable inhibition of glucose consumption,as well as reductions in intracellular ATP and lactate levels.Moreover,this effect was found to be dependent on the dosages of the drugs.In addition to effectively inhibiting the cell cycle,the combination of CAN+DOX induces substantial modifications in both cell cycle and apoptotic gene expression.This work represents the initial report on the beneficial impact of SGLT2 inhibitor medications,namely CAN,DAP,and EMP,on the responsiveness to the anticancer properties of DOX.The underlying molecular mechanisms potentially involve the suppression of the function of SGLT2.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。
基金funded by the Deanship of Scientific Research(DSR),King Abdulaziz University,Jeddah,Saudi Arabia,under Grant No.KEP-1-166-41The authors,therefore,acknowledge DSR,with thanks for their technical and financial support.
文摘Cancer frequently develops resistance to the majority of chemotherapy treatments.This study aimed to examine the synergistic cytotoxic and antitumor effects of SGLT2 inhibitors,specifically Canagliflozin(CAN),Dapagliflozin(DAP),Empagliflozin(EMP),and Doxorubicin(DOX),using in vitro experimentation.The precise combination of CAN+DOX has been found to greatly enhance the cytotoxic effects of doxorubicin(DOX)in MCF-7 cells.Interestingly,it was shown that cancer cells exhibit an increased demand for glucose and ATP in order to support their growth.Notably,when these medications were combined with DOX,there was a considerable inhibition of glucose consumption,as well as reductions in intracellular ATP and lactate levels.Moreover,this effect was found to be dependent on the dosages of the drugs.In addition to effectively inhibiting the cell cycle,the combination of CAN+DOX induces substantial modifications in both cell cycle and apoptotic gene expression.This work represents the initial report on the beneficial impact of SGLT2 inhibitor medications,namely CAN,DAP,and EMP,on the responsiveness to the anticancer properties of DOX.The underlying molecular mechanisms potentially involve the suppression of the function of SGLT2.
