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Sodium‑glucose cotransporter‑2 inhibitors in obesity and associated cardiometabolic disorders: where do we stand?

Natalia G Vallianou1, Dimitrios Tsilingiris2, Dimitris Kounatidis1

  • 1Department of Internal Medicine and Endocrinology, Evangelismos General Hospital, Athens, Greece

Polish Archives of Internal Medicine
|September 12, 2022
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT-2) inhibitors show promise for obesity treatment. These drugs promote weight loss and offer organ protection beyond glucose control, addressing metabolic complications.

Area of Science:

  • Endocrinology and Metabolism
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Rising global obesity rates and associated comorbidities necessitate novel therapeutic agents.
  • Obesity-related disorders include metabolic syndrome, type 2 diabetes (T2D), cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD).
  • Sodium-glucose cotransporter-2 (SGLT-2) inhibitors are approved for T2D but exhibit broader organ-protective effects.

Purpose of the Study:

  • To review the evidence on SGLT-2 inhibitors' effects on body adiposity and their potential as weight-loss agents.
  • To overview the actions and future perspectives of SGLT-2 inhibitors in managing obesity-related complications.
  • To explore therapeutic potential beyond glycemic control, including cardiovascular, renal, ovarian, hepatic, and oncologic aspects.

Main Methods:

  • Comprehensive literature review of current evidence on SGLT-2 inhibitors.
  • Analysis of studies investigating effects on body weight, adiposity, and metabolic parameters.
  • Evaluation of clinical trial data and preclinical research regarding organ protection.

Main Results:

  • SGLT-2 inhibitors demonstrate significant weight-lowering effects, partly independent of glucose reduction.
  • These agents offer benefits for cardiovascular, renal, and hepatic health in patients with T2D and obesity.
  • Emerging evidence suggests potential roles in managing NAFLD, malignancy, and ovarian dysfunction.

Conclusions:

  • SGLT-2 inhibitors represent a promising therapeutic class for obesity and its multifaceted complications.
  • Their unique mechanism of action, including caloric loss via glucosuria, supports their use in weight management.
  • Further research is warranted to fully elucidate their long-term benefits and expand indications.

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