CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Previous studies have shown that sodium-glucose cotransporter 2 (SGLT2) inhibition has a significant impact on both cardiovascular disease and aging. However, available evidence on the relationship between sodium-glucose cotransporter 1 (SGLT1) inhibition and aging is currently very limited. We aimed to investigate the causal effect of SGLT1 inhibition on aging by Mendelian randomization (MR) analysis.

Material and methods:
The summary-level data for SGLT1 inhibition and aging of European ancestry were extracted from publicly available genome-wide association studies (GWAS). The main analysis used in this study was the random inverse variance weighted (IVW) method. We also employed weighted median and the MR-Egger method as supplementary evidence for IVW results. Sensitivity analyses were performed to assess the stability of the results.

Results:
Finally, the exposure data for SGLT1 inhibition were derived from the UK Biobank, including 344,182 European individuals. The GWAS data for telomere length included 472,174 participants, and for frailty index, 175,226 individuals were included. Sixteen single nucleotide polymorphisms (SNPs) that met the SNP screening criteria were retrieved. The results indicated that SGLT1 inhibition increases telomere length (odds ratio [OR]IVW = 1.10, 95% CI: 1.03–1.18; p = 0.007) and reduces the frailty index (OR IVW = 0.84, 95% CI: 0.73–0.95; p = 0.008). No evidence of significant pleiotropy or heterogeneity was observed, which was further substantiated by the sensitivity analysis results.

Conclusions:
The present study determined that SGLT-1 inhibition exhibited a significant negative correlation with aging, suggesting a theoretical basis for the strategy of delaying the aging process.
REFERENCES (42)
1.
Du K, Wang L, Jun JH, et al. Aging promotes metabolic dysfunction-associated steatotic liver disease by inducing ferroptotic stress. Nat Aging 2024; 4: 949-68.
 
2.
Li X, Fan L, Leng SX. The aging tsunami and senior healthcare development in China. J Am Geriatr Soc 2018; 66: 1462-8.
 
3.
Lopes CR, Cunha RA. Impact of coffee intake on human aging: epidemiology and cellular mechanisms. Ageing Res Rev 2024; 102: 102581.
 
4.
Liu RM. Aging, cellular senescence, and Alzheimer’s disease. Int J Mol Sci 2022; 23: 1989.
 
5.
Liberale L, Badimon L, Montecucco F, Luscher TF, Libby P, Camici GG. Inflammation, aging, and cardiovascular disease: JACC review topic of the week. J Am Coll Cardiol 2022; 79: 837-47.
 
6.
Lopez-Otin C, Pietrocola F, Roiz-Valle D, Galluzzi L, Kroemer G. Meta-hallmarks of aging and cancer. Cell Metab 2023; 35: 12-35.
 
7.
Li S, Vandvik PO, Lytvyn L, et al. SGLT-2 inhibitors or GLP-1 receptor agonists for adults with type 2 diabetes: a clinical practice guideline. BMJ 2021; 373: n1091.
 
8.
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145: e895-1032.
 
9.
Katsuumi G, Shimizu I, Suda M, et al. SGLT2 inhibition eliminates senescent cells and alleviates pathological aging. Nat Aging 2024; 4: 926-38.
 
10.
Chen Z, Wu X, Yang Q, et al. The effect of SGLT2 inhibition on brain-related phenotypes and aging: a drug target Mendelian randomization study. J Clin Endocrinol Metab 2024; 110: 1096-104.
 
11.
Bode D, Semmler L, Wakula P, et al. Dual SGLT-1 and SGLT-2 inhibition improves left atrial dysfunction in HFpEF. Cardiovasc Diabetol 2021; 20: 7.
 
12.
Larsson SC, Butterworth AS, Burgess S. Mendelian randomization for cardiovascular diseases: principles and applications. Eur Heart J 2023; 44: 4913-24.
 
13.
Lu H, Lary CW, Hodonsky CJ, et al. Association between BMD and coronary artery calcification: an observational and Mendelian randomization study. J Bone Miner Res 2024; 39: 443-52.
 
14.
Skrivankova VW, Richmond RC, Woolf BAR, et al. Strengthening the reporting of observational studies in epidemiology using mendelian randomization: the STROBE-MR Statement. JAMA 2021; 326: 1614-21.
 
15.
Huang BB, Zhang YJ, Ruan GF, et al. The impact of SGLT1 inhibition on frailty and sarcopenia: a mediation mendelian randomization study. J Cachexia Sarcopenia Muscle 2024; 15: 2693-704.
 
16.
Consortium GT. The GTEx Consortium atlas of genetic regulatory effects across human tissues. Science 2020; 369: 1318-30.
 
17.
Rieg T, Vallon V. Development of SGLT1 and SGLT2 inhibitors. Diabetologia 2018; 61: 2079-86.
 
18.
Xu M, Zheng J, Hou T, et al. SGLT2 inhibition, choline metabolites, and cardiometabolic diseases: a mediation mendelian randomization study. Diabetes Care 2022; 45: 2718-28.
 
19.
Carter AR, Sanderson E, Hammerton G, et al. Mendelian randomisation for mediation analysis: current methods and challenges for implementation. Eur J Epidemiol 2021; 36: 465-78.
 
20.
Chen Z, Zhang K, Peng S, et al. Climate change and air pollution can amplify vulnerability of glucose metabolism: the mediating effects of biological aging. Environ Res 2025; 272: 121183.
 
21.
Gaspar RC, Munoz VR, Nakandakari S, et al. Aging is associated with increased TRB3, ER stress, and hepatic glucose production in the liver of rats. Exp Gerontol 2020; 139: 111021.
 
22.
Sanchez-Garcia A, Rodriguez-Gutierrez R, Mancillas-Adame L, et al. Diagnostic accuracy of the triglyceride and glucose index for insulin resistance: a systematic review. Int J Endocrinol 2020; 2020: 4678526.
 
23.
Pan LY, Jin L. Association between triglyceride glucose index and biological aging in U.S. adults: National Health and Nutrition Examination Survey. Cardiovasc Diabetol 2025; 24: 100.
 
24.
Kim DH, Rockwood K. Frailty in older adults. N Engl J Med 2024; 391: 538-48.
 
25.
Yuan Y, Chen S, Lin C, et al. Association of triglyceride-glucose index trajectory and frailty in urban older residents: evidence from the 10-year follow-up in a cohort study. Cardiovasc Diabetol 2023; 22: 264.
 
26.
Aubert G, Lansdorp PM. Telomeres and aging. Physiol Rev 2008; 88: 557-79.
 
27.
Lin J, Epel E. Stress and telomere shortening: Insights from cellular mechanisms. Ageing Res Rev 2022; 73: 101507.
 
28.
Hu L, Zhang Q, Bai Y, Hu G, Li J. Triglyceride-glucose index correlate with telomere length in healthy adults from the National Health and Nutrition Examination Survey. Front Endocrinol 2022; 13: 844073.
 
29.
Vukasinovic A, Ostanek B, Klisic A, et al. Telomere-telomerase system status in patients with acute myocardial infarction with ST-segment elevation – relationship with oxidative stress. Arch Med Sci 2023; 19: 313-23.
 
30.
Mazidi M, Shekoohi N, Katsiki N, Rakowski M, Mikhailidis DP, Banach M. Serum anti-inflammatory and inflammatory markers have no causal impact on telomere length: a Mendelian randomization study. Arch Med Sci 2021; 17: 739-51.
 
31.
Alahmari M, Elsisi HF, Ismail AMA. Functional outcomes of inspiratory muscle training in elderly with intensive care unit-acquired weakness and severe walking disability. Ir J Med Sci 2025; 194: 761-9.
 
32.
Ismail AMA, Tolba AMN. Effectiveness of lifestyle-modification approach (a randomized-controlled program of diet restriction and treadmill walking exercise) on elderly’s metabolic syndrome-associated subjective tinnitus. Eur Arch Otorhinolaryngol 2025; 282: 4307-15.
 
33.
Zhao M, Li N, Zhou H. SGLT1: a potential drug target for cardiovascular disease. Drug Des Devel Ther 2023; 17: 2011-23.
 
34.
Wright EM, Loo DD, Hirayama BA. Biology of human sodium glucose transporters. Physiol Rev 2011; 91: 733-94.
 
35.
Lehmann A, Hornby PJ. Intestinal SGLT1 in metabolic health and disease. Am J Physiol Gastrointest Liver Physiol 2016; 310: G887-98.
 
36.
Yang JL, Chen WY, Chen YP, Kuo CY, Chen SD. Activation of GLP-1 receptor enhances neuronal base excision repair via PI3K-AKT-induced expression of apurinic/apyrimidinic endonuclease 1. Theranostics 2016; 6: 2015-27.
 
37.
Ramos H, Bogdanov P, Sampedro J, Huerta J, Simo R, Hernandez C. Beneficial effects of glucagon-like peptide-1 (GLP-1) in diabetes-induced retinal abnormalities: involvement of oxidative stress. Antioxidants 2020; 9: 846.
 
38.
Ortiz GU, de Freitas EC. Semaglutide as a possible therapy for healthy aging: targeting the hallmarks of aging. Ageing Res Rev 2024; 102: 102582.
 
39.
Stafeev I, Agareva M, Michurina S, et al. Semaglutide 6-months therapy of type 2 diabetes mellitus restores adipose progenitors potential to develop metabolically active adipocytes. Eur J Pharmacol 2024; 970: 176476.
 
40.
Wen Y, Zhang X, Liu H, et al. SGLT2 inhibitor downregulates ANGPTL4 to mitigate pathological aging of cardiomyocytes induced by type 2 diabetes. Cardiovasc Diabetol 2024; 23: 430.
 
41.
Chen Z, Wu X, Yang Q, et al. The effect of SGLT2 inhibition on brain-related phenotypes and aging: a drug target mendelian randomization study. J Clin Endocrinol Metab 2025; 110: 1096-104.
 
42.
Solini A, Sebastiani G, Nigi L, Santini E, Rossi C, Dotta F. Dapagliflozin modulates glucagon secretion in an SGLT2-independent manner in murine alpha cells. Diabetes Metab 2017; 43: 512-20.
 
eISSN:1896-9151
ISSN:1734-1922
Journals System - logo
Scroll to top