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Current Diabetes Reports

Erschienen in:

01.07.2018 | Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)

Molecular Mechanisms Underlying the Cardiovascular Benefits of SGLT2i and GLP-1RA

verfasst von: Dorrin Zarrin Khat, Mansoor Husain

Erschienen in: Current Diabetes Reports | Ausgabe 7/2018

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Abstract

Purpose of Review

In addition to their effects on glycemic control, two specific classes of relatively new anti-diabetic drugs, namely the sodium glucose co-transporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have demonstrated reduced rates of major adverse cardiovascular events (MACE) in subjects with type 2 diabetes (T2D) at high risk for cardiovascular disease (CVD). This review summarizes recent experimental results that inform putative molecular mechanisms underlying these benefits.

Recent Findings

SGLT2i and GLP-1RA exert cardiovascular effects by targeting in both common and distinctive ways (A) several mediators of macro- and microvascular pathophysiology: namely (A1) inflammation and atherogenesis, (A2) oxidative stress-induced endothelial dysfunction, (A3) vascular smooth muscle cell reactive oxygen species (ROS) production and proliferation, and (A4) thrombosis. These agents also exhibit (B) hemodynamic effects through modulation of (B1) natriuresis/diuresis and (B2) the renin-angiotensin-aldosterone system.

Summary

This review highlights that while GLP-1RA exert direct effects on vascular (endothelial and smooth muscle) cells, the effects of SGLT2i appear to include the activation of signaling pathways that prevent adverse vascular remodeling. Both SGLT2i and GLP-1RA confer hemodynamic effects that counter adverse cardiac remodeling.

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Titel: Molecular Mechanisms Underlying the Cardiovascular Benefits of SGLT2i and GLP-1RA
verfasst von: Dorrin Zarrin Khat
Mansoor Husain
Publikationsdatum: 01.07.2018
Verlag: Springer US
Erschienen in: Current Diabetes Reports / Ausgabe 7/2018
Print ISSN: 1534-4827
Elektronische ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-018-1011-7

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Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

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