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Lipid effects of sodium-glucose cotransporter 2 inhibitors

Julieta Lazarte1,2,3, Tharsan Kanagalingam1, Robert A Hegele1,2,3

  • 1Department of Medicine.

Current Opinion in Lipidology
|April 19, 2021
PubMed
Abstract

Insights

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, used for diabetes, offer significant cardiorenal protection. While they cause minor lipid profile changes, their broad beneficial effects are key to these protective outcomes.

Area of Science:

  • Pharmacology
  • Cardiology
  • Nephrology

Background:

  • Sodium-glucose cotransporter 2 (SGLT2) inhibitors are antihyperglycemic agents.
  • These drugs demonstrate significant cardiorenal protective effects in patients with and without type 2 diabetes.
  • Their efficacy spans diverse baseline renal and cardiac function levels.

Purpose of the Study:

  • To review lipid profile alterations associated with SGLT2 inhibitors.
  • To explore the mechanisms behind these lipid changes in model systems and human studies.

Main Methods:

  • Review of existing literature on SGLT2 inhibitors and lipid profiles.
  • Analysis of data from model systems and human studies investigating SGLT2 inhibitor mechanisms.

Main Results:

  • SGLT2 inhibitors shift substrate utilization from carbohydrates to lipids in diabetic patients.
  • Mild lipid profile effects include increased LDL, HDL, and decreased triglycerides.
  • Increased LDL is linked to hepatic production and reduced catabolism; increased HDL and reduced triglycerides correlate with improved insulin sensitivity and lipolysis.
  • Background diabetes medications and statins modulate these lipid effects.

Conclusions:

  • The minor lipid profile alterations from SGLT2 inhibitors are outweighed by their significant pleiotropic cardiorenal benefits.
  • These pleiotropic mechanisms are crucial for understanding the marked cardiorenal protection offered by SGLT2 inhibitors.

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