Glucagon-like peptide-1-based therapies and cardiovascular disease: looking beyond glycaemic control.
Title | Glucagon-like peptide-1-based therapies and cardiovascular disease: looking beyond glycaemic control. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Anagnostis, P., Athyros V. G., Adamidou F., Panagiotou A., Kita M., Karagiannis A., & Mikhailidis D. P. |
Journal | Diabetes Obes Metab |
Volume | 13 |
Issue | 4 |
Pagination | 302-12 |
Date Published | 2011 Apr |
ISSN | 1463-1326 |
Keywords | Cardiovascular Diseases, Cardiovascular System, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Glucagon-Like Peptide 1, Humans, Hypoglycemic Agents, Male, Receptors, Glucagon |
Abstract | Type 2 diabetes mellitus is a well-established risk factor for cardiovascular disease (CVD). New therapeutic approaches have been developed recently based on the incretin phenomenon, such as the degradation-resistant incretin mimetic exenatide and the glucagon-like peptide-1 (GLP-1) analogue liraglutide, as well as the dipeptidyl dipeptidase (DPP)-4 inhibitors, such as sitagliptin, vildagliptin, saxagliptin, which increase the circulating bioactive GLP-1. GLP-1 exerts its glucose-regulatory action via stimulation of insulin secretion and glucagon suppression by a glucose-dependent way, as well as by weight loss via inhibition of gastric emptying and reduction of appetite and food intake. These actions are mediated through GLP-1 receptors (GLP-1Rs), although GLP-1R-independent pathways have been reported. Except for the pancreatic islets, GLP-1Rs are also present in several other tissues including central and peripheral nervous systems, gastrointestinal tract, heart and vasculature, suggesting a pleiotropic activity of GLP-1. Indeed, accumulating data from both animal and human studies suggest a beneficial effect of GLP-1 and its metabolites on myocardium, endothelium and vasculature, as well as potential anti-inflammatory and antiatherogenic actions. Growing lines of evidence have also confirmed these actions for exenatide and to a lesser extent for liraglutide and DPP-4 inhibitors compared with placebo or standard diabetes therapies. This suggests a potential cardioprotective effect beyond glucose control and weight loss. Whether these agents actually decrease CVD outcomes remains to be confirmed by large randomized placebo-controlled trials. This review discusses the role of GLP-1 on the cardiovascular system and addresses the impact of GLP-1-based therapies on CVD outcomes. |
DOI | 10.1111/j.1463-1326.2010.01345.x |
Alternate Journal | Diabetes Obes Metab |
PubMed ID | 21205117 |