Cargando…

The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials

Aims: Inflammatory biomarkers may play vital roles in the pathophysiology of diabetes and diabetic cardiorenal complications. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have a potential cardiovascular and renal protective effect in type 2 diabetes. The aim of this meta-analysis was to quantif...

Descripción completa

Detalles Bibliográficos
Autores principales: Wang, Dongmei, Liu, Jieying, Zhong, Ling, Li, Shunhua, Zhou, Liyuan, Zhang, Qian, Li, Ming, Xiao, Xinhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717685/
https://www.ncbi.nlm.nih.gov/pubmed/36467062
http://dx.doi.org/10.3389/fphar.2022.1045235
_version_ 1784842940527411200
author Wang, Dongmei
Liu, Jieying
Zhong, Ling
Li, Shunhua
Zhou, Liyuan
Zhang, Qian
Li, Ming
Xiao, Xinhua
author_facet Wang, Dongmei
Liu, Jieying
Zhong, Ling
Li, Shunhua
Zhou, Liyuan
Zhang, Qian
Li, Ming
Xiao, Xinhua
author_sort Wang, Dongmei
collection PubMed
description Aims: Inflammatory biomarkers may play vital roles in the pathophysiology of diabetes and diabetic cardiorenal complications. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have a potential cardiovascular and renal protective effect in type 2 diabetes. The aim of this meta-analysis was to quantify the effects of SGLT2 inhibitors on biomarkers of inflammation in randomized controlled trials (RCTs). Methods: PubMed, Cochrane Library, EMBASE, and Web of Science were searched for eligible RCTs of adults with type 2 diabetes (T2D) with no time limit (updated to 12 October 2022). The biomarkers selected included C-reactive protein (CRP), interleukin-6, tumor necrosis factor-alpha, leptin, adiponectin, ferritin, plasminogen activator inhibitor (PAI)-1, and vascular cell adhesion molecule-1. Data were analyzed using a random-effect model in Review Manager 5.4. Results: Thirty-four studies with 6,261 patients (68.6% male) were eligible for this meta-analysis. The mean age of the participants was 62.57(±11.13) years old, and the median treatment duration length with follow-up was 24 weeks. Generally, the included trials were of good methodological quality. The meta-analysis revealed that ferritin levels were significantly reduced in SGLT2 inhibitor treatment groups versus placebo or standard diabetes therapies (SMD: −1.21; 95% CI: −1.91, −0.52, p < 0.001). The effects of CRP (SMD: 0.25; 95% CI: −0.47, −0.03, p = 0.02) and leptin (SMD: −0.22; 95% CI: −0.43, −0.01, p = 0.04) were reduced, and the effects of adiponectin were improved (SMD: 0.28; 95% CI: 0.15, 0.41, p < 0.001) in placebo-controlled studies. PAI-1 levels were significantly reduced in studies controlled for diabetes therapies (SMD: −0.38; 95% CI: −0.61, −0.15, p = 0.001). Conclusion: This analysis provides strong evidence supporting anti-inflammatory effects of SGLT2 inhibitors in T2D subjects. The mechanisms and possible targets for the inflammation reducing and cardiorenal protective properties of SGLT2 inhibitors remain to be explored.
format Online
Article
Text
id pubmed-9717685
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-97176852022-12-03 The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials Wang, Dongmei Liu, Jieying Zhong, Ling Li, Shunhua Zhou, Liyuan Zhang, Qian Li, Ming Xiao, Xinhua Front Pharmacol Pharmacology Aims: Inflammatory biomarkers may play vital roles in the pathophysiology of diabetes and diabetic cardiorenal complications. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have a potential cardiovascular and renal protective effect in type 2 diabetes. The aim of this meta-analysis was to quantify the effects of SGLT2 inhibitors on biomarkers of inflammation in randomized controlled trials (RCTs). Methods: PubMed, Cochrane Library, EMBASE, and Web of Science were searched for eligible RCTs of adults with type 2 diabetes (T2D) with no time limit (updated to 12 October 2022). The biomarkers selected included C-reactive protein (CRP), interleukin-6, tumor necrosis factor-alpha, leptin, adiponectin, ferritin, plasminogen activator inhibitor (PAI)-1, and vascular cell adhesion molecule-1. Data were analyzed using a random-effect model in Review Manager 5.4. Results: Thirty-four studies with 6,261 patients (68.6% male) were eligible for this meta-analysis. The mean age of the participants was 62.57(±11.13) years old, and the median treatment duration length with follow-up was 24 weeks. Generally, the included trials were of good methodological quality. The meta-analysis revealed that ferritin levels were significantly reduced in SGLT2 inhibitor treatment groups versus placebo or standard diabetes therapies (SMD: −1.21; 95% CI: −1.91, −0.52, p < 0.001). The effects of CRP (SMD: 0.25; 95% CI: −0.47, −0.03, p = 0.02) and leptin (SMD: −0.22; 95% CI: −0.43, −0.01, p = 0.04) were reduced, and the effects of adiponectin were improved (SMD: 0.28; 95% CI: 0.15, 0.41, p < 0.001) in placebo-controlled studies. PAI-1 levels were significantly reduced in studies controlled for diabetes therapies (SMD: −0.38; 95% CI: −0.61, −0.15, p = 0.001). Conclusion: This analysis provides strong evidence supporting anti-inflammatory effects of SGLT2 inhibitors in T2D subjects. The mechanisms and possible targets for the inflammation reducing and cardiorenal protective properties of SGLT2 inhibitors remain to be explored. Frontiers Media S.A. 2022-11-11 /pmc/articles/PMC9717685/ /pubmed/36467062 http://dx.doi.org/10.3389/fphar.2022.1045235 Text en Copyright © 2022 Wang, Liu, Zhong, Li, Zhou, Zhang, Li and Xiao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Wang, Dongmei
Liu, Jieying
Zhong, Ling
Li, Shunhua
Zhou, Liyuan
Zhang, Qian
Li, Ming
Xiao, Xinhua
The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title_full The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title_fullStr The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title_short The effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: A systematic review and meta-analysis of randomized controlled trials
title_sort effect of sodium-glucose cotransporter 2 inhibitors on biomarkers of inflammation: a systematic review and meta-analysis of randomized controlled trials
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717685/
https://www.ncbi.nlm.nih.gov/pubmed/36467062
http://dx.doi.org/10.3389/fphar.2022.1045235
work_keys_str_mv AT wangdongmei theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT liujieying theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhongling theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT lishunhua theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhouliyuan theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhangqian theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT liming theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT xiaoxinhua theeffectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT wangdongmei effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT liujieying effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhongling effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT lishunhua effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhouliyuan effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT zhangqian effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT liming effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
AT xiaoxinhua effectofsodiumglucosecotransporter2inhibitorsonbiomarkersofinflammationasystematicreviewandmetaanalysisofrandomizedcontrolledtrials