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

Iorga,Roua Anamaria; Bacalbasa,Nicolae; Carsote,Mara; Bratu,Ovidiu Gabriel; Stanescu,Ana Maria Alexandra; Bungau,Simona; Pantis,Carmen; Diaconu,Camelia Cristina

doi:10.3892/etm.2020.8714

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

Authors:
- Roua Anamaria Iorga
- Nicolae Bacalbasa
- Mara Carsote
- Ovidiu Gabriel Bratu
- Ana Maria Alexandra Stanescu
- Simona Bungau
- Carmen Pantis
- Camelia Cristina Diaconu
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Affiliations: Internal Medicine Department, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania, Department 13 Obstetrics‑Gynecology, ‘Ion Cantacuzino’ Clinical Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest, Romania, Department 2 Endocrinology, National Institute of Endocrinology ‘C.I. Parhon’, ‘Carol Davila’ University of Medicine and Pharmacy, 011863 Bucharest, Romania, Urology Department, Emergency University Central Military Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 010825 Bucharest, Romania, Family Medicine Department, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania, Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania, Internal Medicine Department, Clinical Emergency Hospital of Bucharest, ‘Carol Davila’ University of Medicine and Pharmacy, 014461 Bucharest, Romania
Published online on: May 5, 2020 https://doi.org/10.3892/etm.2020.8714
Pages: 2396-2400

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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.

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