SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides: Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type

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SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides : Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type. / Bechmann, Louise E.; Emanuelsson, Frida; Nordestgaard, Børge G.; Benn, Marianne.

I: Atherosclerosis, Bind 394, 117236, 2024.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Bechmann, LE, Emanuelsson, F, Nordestgaard, BG & Benn, M 2024, 'SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides: Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type', Atherosclerosis, bind 394, 117236. https://doi.org/10.1016/j.atherosclerosis.2023.117236

APA

Bechmann, L. E., Emanuelsson, F., Nordestgaard, B. G., & Benn, M. (2024). SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides: Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type. Atherosclerosis, 394, [117236]. https://doi.org/10.1016/j.atherosclerosis.2023.117236

Vancouver

Bechmann LE, Emanuelsson F, Nordestgaard BG, Benn M. SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides: Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type. Atherosclerosis. 2024;394. 117236. https://doi.org/10.1016/j.atherosclerosis.2023.117236

Author

Bechmann, Louise E. ; Emanuelsson, Frida ; Nordestgaard, Børge G. ; Benn, Marianne. / SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides : Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type. I: Atherosclerosis. 2024 ; Bind 394.

Bibtex

@article{325fadc993f7460dad1134477b9aab32,
title = "SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides: Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type",
abstract = "Background and aims: Sodium glucose co-transporter 2 (SGLT2)-inhibitors were developed as glucose-lowering drugs. Surprisingly, SGLT2-inhibitors also reduced risk of cardiovascular disease. The impact of SGLT2-inhibitors on lipids and lipoproteins is unclear, but an effect might contribute to the observed lower cardiovascular risk. We conducted a meta-analysis to examine this, overall and by dose, ethnicity, and drug type. Methods: PubMed, EMBASE and Web of Science were searched for randomized controlled trials examining all available SGLT2-inhibitors. Studies with available lipid measurements were included. Quantitative data synthesis was performed using random and fixed effects models. Results: We identified 60 randomized trials, including 147,130 individuals. Overall, using random effects models, SGLT2-inhibitor treatment increased total cholesterol by 0.09 mmol/L (95% CI: 0.06, 0.13), low-density lipoprotein (LDL) cholesterol by 0.08 mmol/L (0.05, 0.10), and high-density lipoprotein (HDL) cholesterol by 0.06 mmol/L (0.05, 0.07), while it reduced triglycerides by 0.10 mmol/L (0.06, 0.14). Fixed effects estimates were similar but with smaller effect sizes for HDL cholesterol and triglycerides. For higher SGLT2-inhibitor doses, there was a nominally higher non-significant effect on lipids and lipoproteins. In Asian compared to non-Asian populations, a slightly larger increase in HDL cholesterol and a decrease in triglycerides were observed, but with similar results for total and LDL cholesterol. Treatment effects on lipids and lipoproteins were generally robust across different SGLT2-inhibitor drugs. Conclusion: In meta-analyses, SGLT2-inhibition increased total, LDL, and HDL cholesterol and decreased triglycerides. Effect sizes varied slightly by drug dose and ethnicity but were generally robust by drug type.",
keywords = "All-cause mortality, Glucose-lowering, Heart failure, Major cardiovascular event, Randomized trial",
author = "Bechmann, {Louise E.} and Frida Emanuelsson and Nordestgaard, {B{\o}rge G.} and Marianne Benn",
note = "Funding Information: This work was supported by the Danish Council for Independent Research (Funding number: 9039-00026B ). Publisher Copyright: {\textcopyright} 2023 The Authors",
year = "2024",
doi = "10.1016/j.atherosclerosis.2023.117236",
language = "English",
volume = "394",
journal = "Journal of atherosclerosis research",
issn = "1567-5688",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - SGLT2-inhibition increases total, LDL, and HDL cholesterol and lowers triglycerides

T2 - Meta-analyses of 60 randomized trials, overall and by dose, ethnicity, and drug type

AU - Bechmann, Louise E.

AU - Emanuelsson, Frida

AU - Nordestgaard, Børge G.

AU - Benn, Marianne

N1 - Funding Information: This work was supported by the Danish Council for Independent Research (Funding number: 9039-00026B ). Publisher Copyright: © 2023 The Authors

PY - 2024

Y1 - 2024

N2 - Background and aims: Sodium glucose co-transporter 2 (SGLT2)-inhibitors were developed as glucose-lowering drugs. Surprisingly, SGLT2-inhibitors also reduced risk of cardiovascular disease. The impact of SGLT2-inhibitors on lipids and lipoproteins is unclear, but an effect might contribute to the observed lower cardiovascular risk. We conducted a meta-analysis to examine this, overall and by dose, ethnicity, and drug type. Methods: PubMed, EMBASE and Web of Science were searched for randomized controlled trials examining all available SGLT2-inhibitors. Studies with available lipid measurements were included. Quantitative data synthesis was performed using random and fixed effects models. Results: We identified 60 randomized trials, including 147,130 individuals. Overall, using random effects models, SGLT2-inhibitor treatment increased total cholesterol by 0.09 mmol/L (95% CI: 0.06, 0.13), low-density lipoprotein (LDL) cholesterol by 0.08 mmol/L (0.05, 0.10), and high-density lipoprotein (HDL) cholesterol by 0.06 mmol/L (0.05, 0.07), while it reduced triglycerides by 0.10 mmol/L (0.06, 0.14). Fixed effects estimates were similar but with smaller effect sizes for HDL cholesterol and triglycerides. For higher SGLT2-inhibitor doses, there was a nominally higher non-significant effect on lipids and lipoproteins. In Asian compared to non-Asian populations, a slightly larger increase in HDL cholesterol and a decrease in triglycerides were observed, but with similar results for total and LDL cholesterol. Treatment effects on lipids and lipoproteins were generally robust across different SGLT2-inhibitor drugs. Conclusion: In meta-analyses, SGLT2-inhibition increased total, LDL, and HDL cholesterol and decreased triglycerides. Effect sizes varied slightly by drug dose and ethnicity but were generally robust by drug type.

AB - Background and aims: Sodium glucose co-transporter 2 (SGLT2)-inhibitors were developed as glucose-lowering drugs. Surprisingly, SGLT2-inhibitors also reduced risk of cardiovascular disease. The impact of SGLT2-inhibitors on lipids and lipoproteins is unclear, but an effect might contribute to the observed lower cardiovascular risk. We conducted a meta-analysis to examine this, overall and by dose, ethnicity, and drug type. Methods: PubMed, EMBASE and Web of Science were searched for randomized controlled trials examining all available SGLT2-inhibitors. Studies with available lipid measurements were included. Quantitative data synthesis was performed using random and fixed effects models. Results: We identified 60 randomized trials, including 147,130 individuals. Overall, using random effects models, SGLT2-inhibitor treatment increased total cholesterol by 0.09 mmol/L (95% CI: 0.06, 0.13), low-density lipoprotein (LDL) cholesterol by 0.08 mmol/L (0.05, 0.10), and high-density lipoprotein (HDL) cholesterol by 0.06 mmol/L (0.05, 0.07), while it reduced triglycerides by 0.10 mmol/L (0.06, 0.14). Fixed effects estimates were similar but with smaller effect sizes for HDL cholesterol and triglycerides. For higher SGLT2-inhibitor doses, there was a nominally higher non-significant effect on lipids and lipoproteins. In Asian compared to non-Asian populations, a slightly larger increase in HDL cholesterol and a decrease in triglycerides were observed, but with similar results for total and LDL cholesterol. Treatment effects on lipids and lipoproteins were generally robust across different SGLT2-inhibitor drugs. Conclusion: In meta-analyses, SGLT2-inhibition increased total, LDL, and HDL cholesterol and decreased triglycerides. Effect sizes varied slightly by drug dose and ethnicity but were generally robust by drug type.

KW - All-cause mortality

KW - Glucose-lowering

KW - Heart failure

KW - Major cardiovascular event

KW - Randomized trial

U2 - 10.1016/j.atherosclerosis.2023.117236

DO - 10.1016/j.atherosclerosis.2023.117236

M3 - Journal article

C2 - 37582673

AN - SCOPUS:85168002082

VL - 394

JO - Journal of atherosclerosis research

JF - Journal of atherosclerosis research

SN - 1567-5688

M1 - 117236

ER -

ID: 388020798