钠-葡萄糖共转运蛋白2抑制剂对骨骼肌影响的研究进展

doi:10.3969/j.issn.1003-9198.2026.10.014

摘要/Abstract

摘要： 钠-葡萄糖共转运蛋白2抑制剂(SGLT2is)是一类新型降糖药物,其通过抑制肾脏对葡萄糖的重吸收,促进尿糖排泄,从而降低血糖水平。SGLT2is因其心肾保护作用,在慢性心力衰竭及慢性肾脏病患者中的应用日益广泛。现有研究证实,SGLT2is可减轻体重,其减重效应可能与促进脂肪氧化有关。然而,减重过程中是否伴随肌肉组织改变仍存在争议。骨骼肌是人体主要的外周代谢器官,是葡萄糖利用与能量代谢的主要场所,其质量和功能变化与患者预后密切相关。本文综述了SGLT2is对骨骼肌肌量、肌力的影响及生物学机制:SGLT2is可能轻度降低骨骼肌肌量,但可通过调节能量代谢、降低氧化应激等途径改善骨骼肌功能,呈现“肌量轻度下降—功能相对稳定/改善”的解离特征。未来需大样本长周期的临床研究试验,界定老年及衰弱人群风险-获益边界。

关键词: 钠-葡萄糖共转运蛋白2抑制剂, 骨骼肌, 2型糖尿病

Abstract: Sodium-glucose cotransporter 2 inhibitors(SGLT2is) are a novel class of glucose-lowering agents that reduce blood glucose levels by inhibiting renal glucose reabsorption and promoting urinary glucose excretion. SGLT2is have been widely used in patients with chronic heart failure and chronic kidney disease due to their established cardiorenal protective effects. Existing evidence has confirmed that SGLT2is can reduce body weight, and their weight-lowering effects may be associated with increased fat oxidation. However, whether weight loss induced by SGLT2is is accompanied by changes in muscle tissue remains controversial. Skeletal muscle, the predominant peripheral metabolic organ, serves as the primary site for glucose utilization and energy metabolism, where changes in mass and function are closely linked to patients’ prognosis. This review synthesizes current evidence regarding the impact of SGLT2is on skeletal muscle mass, muscle strength, and the underlying biological mechanisms: although SGLT2is may cause a slight reduction in skeletal muscle mass, they might improve muscle function by modulating energy metabolism and mitigating oxidative stress. Future large-scale, long-term clinical trials are warranted to define the risk-benefit boundaries of SGLT2is in older adults and frail populations.

Key words: sodium-glucose transporter 2 inhibitors, skeletal muscle, type 2 diabetes mellitus

中图分类号:

R592

王雅冰, 施景文, 阚俊鹏, 孙颖. 钠-葡萄糖共转运蛋白2抑制剂对骨骼肌影响的研究进展[J]. 实用老年医学, 2026, 40(10): 1048-1051.

WANG Yabing, SHI Jingwen, KAN Junpeng, SUN Ying. Research progress on the effects of sodium-glucose cotransporter 2 inhibitors on skeletal muscle[J]. Practical Geriatrics, 2026, 40(10): 1048-1051.

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