Effects of SGLT-2 Inhibitors on Vascular Endothelial Function and Arterial Stiffness in Subjects With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

• Published in: Frontiers in endocrinology (Lausanne) Vol. 13; p. 826604
• Main Authors: Wei, Ran, Wang, Weihao, Pan, Qi, Guo, Lixin
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 16.02.2022
• Subjects: arterial stiffness; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Endocrinology; endothelial function; FMD SGLT-2i; Humans; Hypoglycemic Agents - pharmacology; meta-analysis; PWV; Randomized Controlled Trials as Topic; Sodium-Glucose Transporter 2 Inhibitors - pharmacology; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; type diabetes; Vascular Stiffness; arterial stiffness; endothelial function; meta-analysis; FMD SGLT-2i; type diabetes; PWV
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2022.826604

This systematic review and meta-analysis aimed to evaluate the effects of SGLT-2 inhibitors (SGLT-2i) on endothelial function and arteriosclerosis in diabetic patients. Randomized controlled trials (RCTs) were retrieved from PubMed, Embase, Cochrane Library, and Web of Science databases to evaluate the effects of SGLT-2i on endothelial function and atherosclerosis in type 2 diabetic patients. We selected 9 RCTs and 2 cohort studys involving 868 patients. Of these, six studies provided flow-mediated dilation (FMD) levels before and after the intervention. The pooled analysis showed that SGLT-2i could significantly improve the FMD compared to the control group (SMD: 0.18, 95% CI: 0.02 ~ 0.34, P = 0.03). Three studies provided the change in FMD before and after the intervention. Pooled analysis showed no significant differences in FMD change between the SGLT-2i group and the control group. (MD: 2.1, 95%-CI: -0.11~4.31, P = 0.06). Five studies showed pulse wave velocity (PWV) results. Pooled analysis showed no significant differences in the change in PWV between the SGLT-2i group and the control group (SMD: 0.11, 95%-CI: - 0.15 ~ 0.37, P = 0.4). The ability of SGLT-2 inhibitors to improve FMD was significant, but there was no significant effect on PWV levels. SGLT-2i was superior to other antidiabetic agents in improving arterial endothelial function.