Endocrinology and Metabolism

Review Article

Diabetes, obesity and metabolism
Intrarenal Mechanisms of Sodium-Glucose Cotransporter-2 Inhibitors on Tubuloglomerular Feedback and Natriuresis: Eun Sil Koh, Gheun-Ho Kim, Sungjin Chung; Endocrinol Metab. 2023;38(4):359-372. Published online July 24, 2023; DOI: https://doi.org/10.3803/EnM.2023.1764

14,898 View
761 Download
17 Web of Science
25 Crossref

When sodium-glucose cotransporter-2 (SGLT2) inhibitors were first introduced a decade ago, no one expected them to have substantial effects beyond their known glucose-lowering effects, until the emergence of evidence of their robust renal and cardiovascular benefits showing that they could attenuate progression of kidney disease, irrespective of diabetes, as well as prevent the development of acute kidney injury. Still, the precise and elaborate mechanisms underlying the major organ protection of SGLT2 inhibitors remain unclear. SGLT2 inhibitors inhibit the reabsorption of sodium and glucose in the proximal tubule of the kidney and then recovers tubuloglomerular feedback, whereby SGLT2 inhibitors reduce glomerular hyperfiltration. This simple demonstration of their beneficial effects has perplexed experts in seeking more plausible and as yet undisclosed explanations for the whole effects of SGLT2 inhibitors, including metabolism reprogramming and the modulation of hypoxia, inflammation, and oxidative stress. Given that the renal benefits of SGLT2 inhibitors in patients with kidney disease but without diabetes were comparable to those seen in patients with diabetes, it may be reasonable to keep the emphasis on their hemodynamic actions. In this context, the aim of the present review is to provide a comprehensive overview of renal hemodynamics in individuals with diabetes who are treated with SGLT2 inhibitors, with a focus on natriuresis associated with the regulation of tubuloglomerular feedback and potential aquaresis. Throughout the discussion of alterations in renal sodium and water transports, particular attention will be given to the potential enhancement of adenosine and its receptors following SGLT2 inhibition.

Citations

Citations to this article as recorded by

Sodium‐glucose cotransporter 2 inhibitor ameliorates thiazolidinedione‐induced fluid retention through vascular leakage reduction in white adipose tissue
Ji Yoon Kim, Hye‐Min Jang, Hye‐Jin Lee, Ah Hyeon Lee, Dong‐Hoon Kim, Sin Gon Kim, Nam Hoon Kim
Diabetes, Obesity and Metabolism.2026; 28(3): 1764. CrossRef
Molecular mechanisms of PCSK9 in cardiology: therapeutic implications and clinical impacts on the cardiorenal axis
Sandeep Kaur, Drishti Panjwani, Shareen Singh, Souvik Banerjee, Sukriti Wadehra, Amritpal Kaur, Thakur Gurjeet Singh
Molecular and Cellular Biochemistry.2026;[Epub] CrossRef
Hepatorenal vulnerability flagged by glomerular hyperfiltration in metabolic liver disease: a large health-screening cohort evidence
Dae-Jeong Koo, Yun Tae Kim, Sun-Joon Moon, Hyemi Kwon, Se Eun Park, Sang Min Lee, Cheol-Young Park, Won-Young Lee, Sung Rae Cho, Eun-Jung Rhee
Diabetology & Metabolic Syndrome.2026;[Epub] CrossRef
Effects of SGLT2 inhibitors on NSAID-associated acute kidney injury in type 2 diabetes: a claims-based cohort study
Yuki Kunitsu, Hiroyoshi Koide, Keiko Ikuta, Daiki Hira, Shunsaku Nakagawa, Masahiro Tsuda, Shin-Ya Morita, Tomohiro Terada
BMC Nephrology.2026;[Epub] CrossRef
Redefining SGLT2 inhibitors through cytoprotective mechanisms
Sanja Stankovic, Zoran Miloradovic, Vladimir Petrovic, Milan Stoiljkovic
European Journal of Pharmacology.2026; 1016: 178647. CrossRef
Analysis of the Endocrine Responses to Anti-Diabetes Drugs: An Issue of Elevated Plasma Renin Concentration in Sodium-Glucose Co-Transporter 2 Inhibitor
Cheng-Wei Lin, Shih-Yuan Hung, I-Wen Chen
International Journal of General Medicine.2025; Volume 18: 135. CrossRef
Advances in understanding and managing diabetic kidney disease: An updated review
Elmukhtar Habas, Amnna Rayani, Aml Habas, Kalifa Farfar, Eshrak Habas, Khaled Alarbi, Ala Habas, Elmehdi Errayes, Gamal Alfitori
Ukrainian Journal of Nephrology and Dialysis.2025; (1(85)): 66. CrossRef
Dietary Polyunsaturated Fatty Acid Deficiency Impairs Renal Lipid Metabolism and Adaptive Response to Proteinuria in Murine Renal Tubules
Yaping Wang, Pan Diao, Daiki Aomura, Takayuki Nimura, Makoto Harada, Fangping Jia, Takero Nakajima, Naoki Tanaka, Yuji Kamijo
Nutrients.2025; 17(6): 961. CrossRef
Diuretics: a review of the pharmacology and effects on glucose homeostasis
Mauricio Di Fulvio, Yakshkumar Dilipbhai Rathod, Shorooq Khader
Frontiers in Pharmacology.2025;[Epub] CrossRef
SGLT2 Inhibitors in Cancer Patients: A Comprehensive Review of Clinical, Biochemical, and Therapeutic Implications in Cardio-Oncology
Alessandra Greco, Maria Laura Canale, Vincenzo Quagliariello, Stefano Oliva, Andrea Tedeschi, Alessandro Inno, Marzia De Biasio, Irma Bisceglia, Luigi Tarantini, Nicola Maurea, Alessandro Navazio, Marco Corda, Attilio Iacovoni, Furio Colivicchi, Massimo G
International Journal of Molecular Sciences.2025; 26(10): 4780. CrossRef
Dual-faced guardians: SGLT2 inhibitors’ kidney protection and health challenges: a position statement by Kasralainy nephrology group (KANG)
Amin Roshdy Soliman, Mohamed Elkhatib, Sahier El-Khashab, Rasha Ahmed Darwish, Ahmed Fayed, Tarek S. Abdelaziz, Hany Hammad, Rabab Mahmoud Ahmed, Hoda Abdelhamid Maamoun
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Cardiovascular and Renal Outcomes Following Repeated Naringenin Exposure in Normotensive and Hypertensive Rats
Anelize Dada, Rita de Cássia Vilhena da Silva, Mariana Zanovello, Anelise Felício Macarini, Thaise Boeing, Valdir Cechinel Filho, Priscila de Souza
Pharmaceuticals.2025; 18(6): 873. CrossRef
Investigating the effect of SGLT2 inhibitors on cardiovascular related health status in HFmrEF and HFpEF: systematic review and meta analysis
Tabitha Kusi-Yeboah, Isaac Gianfrancesco, Muzammil Arif Din Abdul Jabbar, Phoebe Collins, Dalton James Bally, Juliet Thornton, Kieran Williams, Ayoola Ishola, Lucy Hong, Ping Jing Toong, Milindu Wickramarachchi
Frontiers in Cardiovascular Medicine.2025;[Epub] CrossRef
Sodium-glucose co-transporter 2 inhibitor-induced increase in adenosine promotes lipolysis and weight reduction by activating reno-adipose autonomic neurocircuitry
Aika Hagiwara, Shintaro Yamaguchi, Kazutoshi Miyashita, Kenichiro Kinouchi, Kaori Hayashi, Hiroshi Itoh
Hypertension Research.2025; 48(10): 2664. CrossRef
Chronic kidney disease in the primary care setting: A narrative review
Faryal Safdar, Ahsan Aslam
Journal of General and Family Medicine.2025; 26(5): 385. CrossRef
Determining the role of SGLT2 inhibitors (dapagliflozin) on progression of proteinuria among non-diabetic adult patients with chronic kidney disease: a randomized controlled trial
Shivam Srivastava, Saurabh Agarwal, Yuvraj Gulati, Alok Kumar Singh, Prakhar Aggarwal
International Journal of Advances in Medicine.2025; 12(6): 553. CrossRef
2025 Taiwan consensus recommendations for primary care of chronic kidney disease
Yi-Chun Tsai, Pei-Yu Wu, Tai-Shuan Lai, Chih-Chien Sung, Yi-Wen Chiu, Shang-Jyh Hwang, Yung-Ho Hsu, Mai-Szu Wu, Chung-Liang Shih
Journal of the Formosan Medical Association.2025;[Epub] CrossRef
Bridging Cardiorenal and Hepatic Disease: The Emerging Role of SGLT2 Inhibitors in Cirrhosis
Omar Alkasabrah, Sameeha Ibrahim, Abdullah Hafeez, Muhammad Qasim Chaudhry, Faiza Jajja, Maharshi Raval, Hritvik Jain, Darshil Maheta, Siddharth Pravin Agrawal, William H. Frishman, Wilbert S. Aronow
Cardiology in Review.2025;[Epub] CrossRef
Efficacy and safety of metformin versus empagliflozin on chronic kidney disease progression (MET-EMPA-CKD): a randomized controlled trial
Bassant M. Mahboub, Ayman F. Refaie, Sahar M. El-Haggar, Yasser M. Hafez, Tarek M. Mostafa
Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Results from a cross-specialty consensus on optimal management of patients with chronic kidney disease (CKD): from screening to complications
Mustafa Arici, Samir Helmy Assaad-Khalil, Marcello Casaccia Bertoluci, Jason Choo, Yau-Jiunn Lee, Magdalena Madero, Guillermo Javier Rosa Diez, Vicente Sánchez Polo, Sungjin Chung, Teerawat Thanachayanont, Carol Pollock
BMJ Open.2024; 14(3): e080891. CrossRef
Chronic Kidney Disease and SGLT2 Inhibitors
Eun Sil Koh, Sungjin Chung
The Journal of Korean Diabetes.2024; 25(1): 16. CrossRef
Genitourinary Tract Infections in Patients Taking SGLT2 Inhibitors
Veraprapas Kittipibul, Zachary L. Cox, Supavit Chesdachai, Mona Fiuzat, JoAnn Lindenfeld, Robert J. Mentz
Journal of the American College of Cardiology.2024; 83(16): 1568. CrossRef
Effects of Sodium–Glucose Co-Transporter 2 Inhibitors on Serum Chloride Concentrations in Patients with Heart Failure
Ivana Jurin, Vanja Ivanović Mihajlović, Zrinka Šakić, Marin Pavlov, Tomislav Šipić, Petra Vitlov, Hrvoje Falak, Danijela Grizelj, Šime Manola, Mario Udovičić
Journal of Cardiovascular Development and Disease.2024; 11(11): 364. CrossRef
Hemodynamic Effects of SGLT2 Inhibitors in Patients with and Without Diabetes Mellitus—A Narrative Review
Roxana Brata, Andrei Vasile Pascalau, Ovidiu Fratila, Ioana Paul, Mihaela Mirela Muresan, Andreea Camarasan, Tiberia Ilias
Healthcare.2024; 12(23): 2464. CrossRef
Synopsis of the Korean Society of Nephrology 2023 Practical Recommendations for the Management of Diabetic Kidney Disease
Sungjin Chung
The Korean Journal of Medicine.2023; 98(6): 270. CrossRef

Original Article

Clinical Study
Characteristics of Body Composition and Muscle Strength of North Korean Refugees during South Korean Stay: Sun Wook Cho, So Hee Lee, Eun Sil Koh, Si Eun Kim, Seok Joong Kim; Endocrinol Metab. 2015;30(4):551-556. Published online December 31, 2015; DOI: https://doi.org/10.3803/EnM.2015.30.4.551

6,487 View
44 Download
3 Web of Science
6 Crossref

Abstract PDF PubReader

Background

The aim of this study was to investigate the changes of body composition and muscle strength of North Korean refugees (NKRs) according to their duration of stay in South Korea.

Methods

NKRs who volunteered and were living in South Korea, aged 20 to 75 years were recruited. Body compositions were analyzed by bioelectrical impedance analysis. Muscle strength was measured with the hand grip test. Demographic and migration information was obtained with a questionnaire.

Results

A total of 158 volunteers were recruited at a mean age of 48.3±11.4 years. The mean time from when they escaped from North Korea and arrived in South Korea was 5.8±4.3 years. Height, weight, and body surface area were significantly smaller in all NKRs compared to South Korean controls, except for women aged over 50 years. In females of younger ages (<50 years), NKRs with more than a 4-year stay in South Korea had a higher weight and fat mass than that of those who had a shorter stay (less than 4 years) in South Korea. All NKRs had a weaker grip strength than that of the age-matched controls from South Korea.

Conclusion

The NKRs showed relatively smaller physiques and weaker muscle strength than that of the South Korean controls. In younger female NKRs, shorter South Korean stay group showed small body weight and fat mass than that of longer South Korean stay group. Specific health support programs might be needed.

Citations

Citations to this article as recorded by

Physical Fitness and Health-Related Quality of Life Among North Korean Defectors: Focusing on the Jangmadang and Arduous March Generations
Do-Hee Kim, Jung-Woo Oh, Yeon-Soo Kim, Yunmin Han, Younghwan Choi, Joo-Young Lee
Journal of The Korean Society of Living Environmental System.2025; 32(6): 753. CrossRef
Thermal Perception and Wearing Habits among North Korean Residents: An Integrated Approach to Living Environments Based on the Experiences of North Korean Defectors
Do-Hee Kim, Young-hee Kim, Yeo-Sang Yoon, Jung-Woo Oh, Joo-Young Lee
Journal of The Korean Society of Living Environmental System.2025; 32(6): 790. CrossRef
Assessment of diet quality of adults from North Korea: using nutrition quotient (NQ) for Korean adults
SaeByeol Kwon, Kyoung-Nam Kim, Moon-Kyung Shin
Journal of Nutrition and Health.2023; 56(2): 217. CrossRef
Associations between grip strength, cardiorespiratory fitness, cardiovascular risk and mental health in forcibly displaced people from a Greek refugee camp
Markus Gerber, Konstantinia Filippou, Florian Knappe, Ioannis D. Morres, Emmanouil Tzormpatzakis, Elsa Havas, Harald Seelig, Flora Colledge, Sebastian Ludyga, Marianne Meier, Yannis Theodorakis, Roland von Känel, Uwe Pühse, Antonis Hatzigeorgiadis
Scientific Reports.2023;[Epub] CrossRef
Weight Gain Predicts Metabolic Syndrome among North Korean Refugees in South Korea
Yoon Jung Kim, Yo Han Lee, Yun Jeong Lee, Kyeong Jin Kim, Sin Gon Kim
International Journal of Environmental Research and Public Health.2021; 18(16): 8479. CrossRef
Prevalence of General and Central Obesity and Associated Factors among North Korean Refugees in South Korea by Duration after Defection from North Korea: A Cross-Sectional Study
Yoon Jung Kim, Sin Gon Kim, Yo Han Lee
International Journal of Environmental Research and Public Health.2018; 15(4): 811. CrossRef

First
Prev
Page of 1
Next
Last

Search