Metabolic and cardiovascular benefits of GLP-1 agonists, besides the hypoglycemic effect (Review) - PubMed (original) (raw)

Review

Metabolic and cardiovascular benefits of GLP-1 agonists, besides the hypoglycemic effect (Review)

Roua Anamaria Iorga et al. Exp Ther Med. 2020 Sep.

Abstract

Patients with type 2 diabetes exhibit higher cardiovascular risk than normal individuals. Optimal blood glucose levels are rarely achieved in diabetic patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a new antidiabetic drug class with multiple metabolic effects. Some trials have evaluated their safety, but it has been recently demonstrated that this new class has cardiovascular benefits, through other mechanisms than glycemic control. The use of GLP-1RAs was associated with a significant reduction of cardiovascular and all-cause mortality, with a safe profile related to pancreatitis or thyroid cancer, as compared with placebo. This review presents the cardiovascular and metabolic benefits of GLP-1 RAs versus placebo, in patients with type 2 diabetes. Semaglutide and liraglutide demonstrated a reduction in cardiovascular events, with similar rates on cardiovascular mortality. Ongoing trials assess the cardiovascular benefits and side effects of dulaglutide treatment. Exenatide and liraglutide demonstrated the decrease of blood pressure values, weight reduction and improvement of dyslipidemia. Liraglutide induced, both in vivo and in vitro, an improvement of blood circulation, increasing the nitric oxide level and inhibiting the adhesion and procoagulant factors. Also, liraglutide demonstrated beneficial effects on cardiac remodeling after myocardial infarction, but more large trials are required. However, the international guidelines recommend using GLP-1 RAs as first-line therapy in type 2 diabetes patients with high cardiovascular risk or as first-line agents in patients intolerant to metformin.

Keywords: atherosclerosis; cardiovascular effect; dyslipidemia; glucagon-like peptide-1 receptor agonists; type 2 diabetes.

Copyright © 2020, Spandidos Publications.

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References

    1. New WHO statistics highlight increases in blood pressure and diabetes, other noncommunicable risk factors. Cent Eur J Public Health. 2012;20:134–149. No authors listed. 149. - PubMed
    1. Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6:1246–1258. doi: 10.4239/wjd.v6.i13.1246. - DOI - PMC - PubMed
    1. Kovacic JC, Castellano JM, Farkouh ME, Fuster V. The relationships between cardiovascular disease and diabetes: Focus on pathogenesis. Endocrinol Metab Clin North Am. 2014;43:41–57. doi: 10.1016/j.ecl.2013.09.007. - DOI - PubMed
    1. Dupré J, Behme MT, McDonald TJ. Exendin-4 normalized postcibal glycemic excursions in type 1 diabetes. J Clin Endocrinol Metab. 2004;89:3469–3473. doi: 10.1210/jc.2003-032001. - DOI - PubMed
    1. Sposito AC, Berwanger O, de Carvalho LSF, Saraiva JFK. GLP-1RAs in type 2 diabetes: Mechanisms that underlie cardiovascular effects and overview of cardiovascular outcome data. Cardiovasc Diabetol. 2018;17(157) doi: 10.1186/s12933-018-0800-2. - DOI - PMC - PubMed

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