GLP-1受体激动剂联合SGLT-2抑制剂对2型糖尿病合并非酒精性脂肪性肝病的研究进展
Research Progress on the Combination of GLP-1 Receptor Agonists and SGLT-2 Inhibitors in Type 2 Diabetes Mellitus Complicated with Non-Alcoholic Fatty Liver Disease
摘要: 2型糖尿病(Type 2 Diabetes Mellitus, T2DM)与非酒精性脂肪性肝病(Nonalcoholic Fatty Liver Disease, NAFLD)均为全球高发的代谢性疾病，二者存在双向病理关联，显著增加心血管与肝脏相关并发症风险。胰高血糖素样肽-1受体激动剂(GLP-1 RAs)与钠–葡萄糖协同转运蛋白-2抑制剂(SGLT-2i)作为新型降糖药物，分别通过肠促胰素效应与肾脏排糖机制发挥作用，且均展现出独立于降糖之外的多器官保护潜力。本文系统综述GLP-1 RAs联合SGLT-2i治疗T2DM合并NAFLD的研究进展，从疾病共病机制切入，深入分析联合用药的协同作用机制，全面总结临床疗效证据，探讨安全性特征，并展望未来研究方向，为临床治疗策略优化提供参考。
Abstract: Type 2 Diabetes Mellitus (T2DM) and Nonalcoholic Fatty Liver Disease (NAFLD) are both highly prevalent metabolic disorders worldwide, with a bidirectional pathological association that significantly increases the risk of cardiovascular and liver-related complications. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are novel antidiabetic drugs that exert their effects through incretin and renal glucose excretion mechanisms, respectively, and both have demonstrated multi-organ protective potential independent of their glucose-lowering effects. This article systematically reviews the research progress of the combination of GLP-1 RAs and SGLT-2i in the treatment of T2DM with NAFLD. Starting from the mechanism of disease comorbidity, it deeply analyzes the synergistic mechanism of combined medication, comprehensively summarizes the clinical efficacy evidence, explores safety characteristics, and looks forward to future research directions, providing a reference for the optimization of clinical treatment strategies.
文章引用：孙源, 孙昕昳. GLP-1受体激动剂联合SGLT-2抑制剂对2型糖尿病合并非酒精性脂肪性肝病的研究进展[J]. 临床医学进展, 2025, 15(12): 1997-2004. https://doi.org/10.12677/acm.2025.15123619

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