Emerging role of antidiabetic drugs in cardiorenal protection

Front Pharmacol. 2024 Feb 6:15:1349069. doi: 10.3389/fphar.2024.1349069. eCollection 2024.

Abstract

The global prevalence of diabetes mellitus (DM) has led to widespread multi-system damage, especially in cardiovascular and renal functions, heightening morbidity and mortality. Emerging antidiabetic drugs sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RAs), and dipeptidyl peptidase-4 inhibitors (DPP-4i) have demonstrated efficacy in preserving cardiac and renal function, both in type 2 diabetic and non-diabetic individuals. To understand the exact impact of these drugs on cardiorenal protection and underlying mechanisms, we conducted a comprehensive review of recent large-scale clinical trials and basic research focusing on SGLT2i, GLP-1RAs, and DPP-4i. Accumulating evidence highlights the diverse mechanisms including glucose-dependent and independent pathways, and revealing their potential cardiorenal protection in diabetic and non-diabetic cardiorenal disease. This review provides critical insights into the cardiorenal protective effects of SGLT2i, GLP-1RAs, and DPP-4i and underscores the importance of these medications in mitigating the progression of cardiovascular and renal complications, and their broader clinical implications beyond glycemic management.

Keywords: DPP-4 inhibitors; GLP-1 receptor agonists; SGLT2 inhibitors; cardiorenal protection; diabetes mellitus.

Publication types

  • Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Henan Province (222300420089 to PW), National Natural Science Foundation of China (32371170 to Z-XG, 31971065 to PW, and 82300323 to J-LH), and Scientific Research and Innovation Team of the First Affiliated Hospital of Zhengzhou University (QNCXTD2023006 to PW).