EFFECT OF SGLT2 INHIBITORS ON MITOCHONDRIAL FUNCTION, LIPID METABOLISM AND ATHEROGENESIS IN PATIENTS WITH TYPE 2 DIABETES (LITERATURE REVIEW AND OWN DATA)
DOI:
https://doi.org/10.21856/j-PEP.2023.4.10Keywords:
SGLT2 inhibitors, type 2 diabetes, lipids, mitochondria, atherosclerosis, reviewAbstract
With diabetes, the metabolism, composition and ratio of lipids changes significantly. They are considered to be the main metabolic substrates that accumulate and produce energy necessary for the cell. However, their normal metabolism is altered in the diabetic environment and may contribute to the development of dyslipidemia-dependent complications such as cardiovascular diseases. Therefore, normalization of lipid metabolism in diabetes is important to reduce the level of harmful byproducts, and to prevent cell damage and diabetic complications caused by dyslipidemia. There is a large body of evidence that SGLT2 inhibitors affect blood lipids. The results of clinical studies showed that in patients with type 2 diabetes, iSGLT2 caused an increase in LDL-C and HDL-C levels, and a decrease in triglycerides. SGLT2 inhibitors have a significant effect on lipolysis and lipogenesis. The impact of iSGLT2 on cholesterol homeostasis, absorption and utilization of fatty acids (β-oxidation), lipid peroxidation, absorption and transport of lipids, obesity, accumulation of fat in the liver and other tissues has been proven. iSGLT2 effectively induce weight loss in patients with type 2 diabetes. Therefore, SGLT inhibitors should be considered in diabetic patients with uncontrolled weight. iSGLT2 can modulate and normalize mitochondrial function by inhibiting ROS overproduction and reducing mitochondrial oxidative stress. Thus, SGLT2 inhibitors can affect the level of indicators of lipid metabolism, mitochondrial function, inflammatory processes, oxidative stress, endothelial function and autophagy, which leads to the reduction of the serious cardiovascular complications risk and the number of hospitalizations due to heart failure. However, the mechanisms of impact of the above-mentioned compounds on indicators of lipid metabolism and other biochemical processes require further thorough study.
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